Librela

RE: Librela

Stephen Courtney — Tue, 16 Aug 2022 06:34:54 GMT

You can give meloxicam to old CRD cats but very carefully - no such issue with solensia

I have long suspected you have a different client population to everyone else - we have to document detailed discussions about risks and monitoring and clients wishes etc otherwise sooner or later someone will blame you for their 21 year old diabetic cat getting terminal CRD because you gave it metacam for a sore tooth last week

RE: Librela

Michael Woodhouse — Sun, 14 Aug 2022 20:43:19 GMT

[quote userid="4256" url="~/001/veterinary-clinical/small-animal/orthopaedics/f/discussions/30375/librela/238623#238623"] for knackered old cats with questionable renal function[/quote]

as is meloxicam........

RE: Librela

Clare Tapsfield-Wright — Sun, 14 Aug 2022 14:46:57 GMT

Ah sounds like my lab with her elbows . I agree re living a dogs life , I would rather she had a shorter but happy one being a proper dog .

RE: Librela

Neil Wheadon — Sun, 14 Aug 2022 12:19:11 GMT

[quote userid="2675" url="~/001/veterinary-clinical/small-animal/orthopaedics/f/discussions/30375/librela/238628#238628"]second is the life span of our patients much shorter and owners will generally subscribe to shorter but good (even exceptional) lifespan [/quote]

This is key isn't it?

A dog gets arthritis at maybe 8 years of age where some sort of intervention is needed. The average dog will live to 13 years.

Surely it's better to use anything that allows a dog to do what they want to do, go for a walk, chase a ball etc, it's all about quality of life for both dog and owner.

In regards reduction of exercise with arthritis, why do we say that? Maybe it causes some damage, but a dog is on the planet to enjoy itself, not cooped up doing 10 minutes of exercise a day.

Neil

PS Librela, love it, had one case that the owner wasn't happy with. That was a 6 year old labrador with elbows maybe twice the size of normal

RE: Librela

Clive Ansell — Sat, 13 Aug 2022 10:54:01 GMT

Also, from the data sheet.

Contra-indications, warnings, etc - Librela® solution for injection for dogs (noahcompendium.co.uk)

Laboratory studies with anti-NGF antibodies in cynomolgus monkeys have shown evidence of teratogenic and foetotoxic effects.

The importance of Nerve Growth Factor in ensuring normal foetal nervous system development is well-established and laboratory studies conducted on non-human primates with human anti-NGF antibodies have shown evidence of reproductive and developmental toxicity. Pregnant women, women trying to conceive and breastfeeding women should take extreme care to avoid accidental self-injection.

I have only started 2 cases on it, but have seen many others for repeat injections. It does seem to work very well, and all cases I have seen are off all types of analgesics.

RE: Librela

Richard Carter — Sat, 13 Aug 2022 04:56:31 GMT

Think we just have to remember there is a reason these drugs have been withdrawn from the human side- they are linked with higher levels of cancer - don’t know if been proved they cause it or just remove the body defence so existing cancer gets going. This includes librela, solensia, apoquel, cytopoint all in the same group of inflammation blockers

there various arguments to continue using in our patients- first is they already in trouble and other meds failing or also causing side effects

second is the life span of our patients much shorter and owners will generally subscribe to shorter but good (even exceptional) lifespan

RE: Librela

Alistair Graham-Evans — Sat, 13 Aug 2022 02:41:38 GMT

Thanks Steve

I was going to ask about Solensia - still to be licensed in Australia where the authorities move at snail’s pace.

RE: Librela

Stephen Courtney — Fri, 12 Aug 2022 18:56:13 GMT

I have several dogs with severe DJD that are on 'everything' - nsaid, amantadine, paracetamol,gabapentin...and then added librela.

It isn't licensed to use that way but informed consent etc...I've had no issues re side effects, but not every dog can respond, it depends how bad the joints are I guess.

and one case actually turned out to have a spinal cord tumour , slowly progressing, causing increasing ataxia which just happened to look like progressive DJD which he also had ...needles to say librela didn't change that one iota

But I've had several cases do brilliantly - and can say the same for solensia - in fact this drug is a game changer for knackered old cats with questionable renal function

RE: Librela

Julie Innes — Tue, 09 Aug 2022 08:58:41 GMT

I've had mixed reactions- some clients hail it as a wonder drug, others have given it up after 4 or so injections.

PU/PD is the most common side effect we've seen, but according to the rep this should be transient.

RE: Librela

Elizabeth — Tue, 09 Aug 2022 08:46:21 GMT

Should edit to say that I tell people to stick to their pre-librela exercise regime.

RE: Librela

Alistair Graham-Evans — Tue, 09 Aug 2022 08:45:23 GMT

[quote userid="6897" url="~/001/veterinary-clinical/small-animal/orthopaedics/f/discussions/30375/librela/238554#238554"]Pain may be reduced - but the joint is still knackered.[/quote]

Yes - there is the mechanical stiffness and the pain factor, but also the stresses on the other joints.

So frustrating and sad in a young dog - as Colin Whiting said in his video presentation on here, a good reason to ( finances permitting) encourage appropriate surgery for cruciate disease in good time.

RE: Librela

Elizabeth — Tue, 09 Aug 2022 08:27:32 GMT

I generally tell people not to stick to current exercise regime, as I e read elsewhere that dogs were suddenly increasing their exercise levels as they felt so good, leading to the OA getting worse quicker. ( just repeated anecdote though!)

RE: Librela

bob lehner — Tue, 09 Aug 2022 07:08:18 GMT

[quote userid="6765" url="~/001/veterinary-clinical/small-animal/orthopaedics/f/discussions/30375/librela/238553#238553"]Elbows are quite unforgiving joints and so complex[/quote]

Surely it is unrealistic to expect much visible improvement when a joint is seized up due to boney proliferation etc. which limits the range of movement.

Pain may be reduced - but the joint is still knackered.

RE: Librela

Alistair Graham-Evans — Tue, 09 Aug 2022 03:52:48 GMT

Sorry to hear that Clare.

Elbows are quite unforgiving joints and so complex.

I am hoping that Librela may be an alternative for the occasional dog that can’t tolerate NSAIDS.

RE: Librela

Miriam Lodewyks — Sun, 07 Aug 2022 11:27:22 GMT

Pretty good so far, mostly effective, occasionally no change. No real side effects, except my own ancient terrier who developed significant ataxia after about 7 injections (probably unrelated but can’t explain it either).

RE: Librela

Clare Tapsfield-Wright — Fri, 05 Aug 2022 15:53:03 GMT

This is only my personal experience , one case , but I’m a bit disappointed with Librella with my lab who is six years old and has bilateral elbow arthritis DJD . She is no worse than on meloxicam but not markedly better. Possibly just deterioration and would have happened with anything but I’m sad to have a relatively young lab who can’t run around or go for a walk for an hour without considerable lameness. She has had four librella so far and I’m going to continue but I’ve had to give paracetomol too. I was hoping for a miracle perhaps

RE: Librela

Alistair Graham-Evans — Fri, 05 Aug 2022 12:36:02 GMT

Good to know- hope it gets passed here soon!

RE: Librela

Joyce Whitehead — Thu, 04 Aug 2022 19:13:02 GMT

Absolutely brilliant. Quite a game changer in fact.

RE: Librela

Elizabeth — Thu, 04 Aug 2022 13:48:32 GMT

It’s amazing.

RE: Librela

niall morton — Wed, 03 Aug 2022 22:25:57 GMT

It’s the mutts nuts!