The most commonly prescribed medication for dogs with osteoarthritis has for many years been one of a group of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Names you might recognise are Rimadyl, Metacam, Previcox and Onsior. Your dog may be taking one of these drugs now or they may have had them for other conditions in the past.
The way NSAIDs work is by reducing the production of prostaglandins which are one of the mediators of inflammation associated with osteoarthritis. NSAIDs do this by blocking an enzyme called cyclo-oxygenase. However, there are at least two forms of this enzyme, cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2). It is COX-2 which is the chief culprit for creating these inflammatory prostaglandins. COX-1 actually produces prostaglandins that are protective within the body as they protect the stomach lining, aid in kidney function and help with blood clotting. Reducing the production of prostaglandins therefore sometimes affects these beneficial jobs that prostaglandins do. This is when we sometimes see side effects such as gastro-intestinal ulcers, kidney issues and blood clotting problems. Developments in NSAIDs have created more COX-2 selective drugs which have reduced the side effects seen, however adverse reactions can still happen.
NSAIDs have had a lot of bad publicity regarding their potential side-effects but they are generally very safe drugs to use and their benefits far out-weigh the potential risks.
However, veterinary medicine is continually progressing, and we now have an exciting new therapy available! This month a product was released onto the market which has given us a brand new treatment choice for dogs with osteoarthritis. This is probably the biggest advance in treating osteoarthritis pain in dogs that I have seen in 25 years of being a vet!
Librela – anti-nerve growth factor (anti-NGF)
Nerve growth factor (NGF) is another inflammatory mediator that is involved in the pain pathway of osteoarthritis and is another target that can be blocked to prevent pain transmission.
An anti-NGF drug, called a monoclonal antibody, has been developed that blocks NGF. Monoclonal antibodies have several advantages over other drugs. They have a long duration of action, they are injectable, and they have a very low risk of side effects. The anti-NGF monoclonal antibody that has been brought to the veterinary market is called bedinvetmab and is marketed as ‘Librela’. It is very easy to administer as a once-a-month injection and it is very safe to use.
I have already tried this out on one of my acupuncture patients and the results are very promising!
This product is only for use in dogs but feline specific anti-NGF monoclonal antibodies are also on their way for cats.
Pain relief is key to managing a pet with a chronic condition such as osteoarthritis. Combining a number of treatments (including acupuncture) is recognised as the most effective way of controlling pain with minimum side-effects.
If you would like more information on the latest treatments available and to find out the best way to manage your pet then please contact us!
KS Veterinary Acupuncture 