All dog owners want the best for their canine companions. If we could have one wish granted, it would be to turn time back to the days when running, jumping, long walks in the woods and playing in the park were easy and pain-free for our dogs.
The Long Search for Options in Pain Management:
The quest to help relieve arthritis pain in dogs has been a long one. For many years, slowing down an older dog’s activity level was one of the few options available for pain management. Some veterinarians prescribed aspirin or even steroids, but side effects such as bleeding, stomach ulcers and stomach upset were common for aspirin. Increased thirst, increased urination and a host of other issues plagued steroid users. These side effects, coupled with minimal efficacy, had the veterinary community searching for the Holy Grail of pain relief.
More diverse options for pain relief slowly found their way to the veterinary community. Dr. Allen Schoen established the first Veterinary Acupuncture Department in America at the Animal Medical Center in 1982. This was a landmark accomplishment, as it was the first such facility outside of China. Meanwhile, the veterinary division of Pfizer Pharmaceuticals was also busy searching for a safer and more efficacious source of pain control in dogs.
In January 1997, Rimadyl, a non-steroidal anti-inflammatory drug (NSAID), was launched. It remains a safe, tried and true means of providing comfort to our dogs. In fact, many of you reading this will have past or present experience with this medication. Despite a much-improved safety profile compared to aspirin or steroids, Rimadyl must be used cautiously with attention to proper patient selection. Some dogs develop stomach ulcers, kidney problems or liver issues in response to continued use. More NSAID type drugs, with claims of fewer side effects or safety concerns, have been developed since Rimadyl was introduced. However, monitoring blood work on a continuing basis is extremely important when using any type of NSAID.
Still, other types of pain relief designed to be used in conjunction with NSAIDs have been brought to the market over recent years. Adequan, an injectable FDA-approved medication classified as a polysulfated glycosaminoglycan, has been proven to 1) slow down and 2) reverse cartilage degeneration in joints. Food supplements containing chondroitin, vitamin supplements and even CBD have been tried, often with little effect. Other non-pharmaceutical interventions such as laser therapy, physical therapy, massage and acupuncture are becoming more mainstream.
A New Approach:
Many of our dog owners also share their homes with cats. Often we find cats develop arthritis and pain secondary to the disease as they age. Many of our clients are highly satisfied with the increased comfort and enhanced quality of life their cats have experienced after starting Solencia, a new monoclonal antibody designed to treat pain in cats. We are extremely excited to tell our Longwood clients that a similar, effective monoclonal antibody therapy has also been developed for dogs.
An Introduction to Librela:
Monoclonal antibodies are man-made proteins that mimic the function of antibodies in our immune system. They are designed to target and destroy or diminish the effects of specific cells (as in cancer cells), proteins (such as NGF involved in pain perception), or foreign invaders (such as the COVID virus). These engineered antibodies are very specific and have a high safety profile.
The monoclonal antibody, Librela, was designed to target NGF (Nerve Growth Factor). NGF is found in mammalian systems and plays a huge role in the perception of pain in arthritic joints. NGF is responsible for the growth, survival and maintenance of neurons. From a survival standpoint, it is very important for us to recognize pain. However, in inflamed and arthritic joints, too much NGF can be a bad thing. NGF is responsible for making local neurons and ultimately the entire central nervous system more sensitive to pain. Finally, NGF stimulates macrophages (a type of inflammatory cell) in the joint to produce more inflammation. It is a vicious and painful cycle.
In targeting and neutralizing NGF, Librela ensures that NGF cannot activate the above inflammatory and pain-sensitizing pathways. Monoclonal antibodies, such as Librela, are broken down and eliminated safely by the body, just as other proteins are. For a video explaining the mechanism of action, safety, and efficacy of Librela see this link: https://www.librelavetteam.com/
How is Librela Administered?
Librela is a subcutaneous (under the skin) injection given once monthly by a veterinary professional. Studies performed in both the United States and the European Union showed significant clinical improvement in many dogs within as little as 7 days. However, do not be discouraged if your pet takes longer to show an improvement. Improvement was measured through the implementation of the CBPI scale (Canine Brief Pain Inventory Scale). This survey was developed to help quantify pain in canine patients, making it scientifically possible to measure pain in dogs before and after a given treatment. Visit the link here: Penn Vet | CBPI Tool.
We hope you are as excited about Librela as we are! Be sure to discuss any signs of pain you recognize in your pets with your Longwood Veterinary Center veterinarian at your next visit. Your dog will thank you for it.
Dr. Corrina Snook Parsons VMD, DACVIM (LA)