Are you seeing cases where Librela has stopped working?

RE: Are you seeing cases where Librela has stopped working?

janine redman — Wed, 14 Feb 2024 13:10:41 GMT

Interesting in that on a few of the dogs where I have stopped the librela the dogs neurological function has gradually improved and their mental attitude to . I am just about to stop the injections in a 16 year old collie with a very dedicated owner who writes down every nuance of behaviour. This dog after 6 librela injections has gone from being sore to being weak and knuckling on forelimbs and hindlimbs and is now also staring at walls . It will be interesting to see if she improves or deteriorates with cessation of librela

RE: Are you seeing cases where Librela has stopped working?

Richard Carter — Wed, 14 Feb 2024 11:27:37 GMT

And the recovery when librela stopped- I’ve seen a few now

RE: Are you seeing cases where Librela has stopped working?

cairncross — Tue, 13 Feb 2024 09:12:23 GMT

If we do is it because the meds are keeping the dog ambulating well enough long enough to notice ?

RE: Are you seeing cases where Librela has stopped working?

Rob Loxley — Tue, 13 Feb 2024 07:59:20 GMT

[quote userid="19228" url="~/f/clinical-questions/30893/are-you-seeing-cases-where-librela-has-stopped-working/243722#243722"]i think decline in locomotion in elderly arthritic/;locomotor cases is an expected event[/quote]

But do we see more progressing with neurological issues such as ataxia, on such meds than if not on them?

RE: Are you seeing cases where Librela has stopped working?

cairncross — Tue, 13 Feb 2024 07:31:58 GMT

i think decline in locomotion in elderly arthritic/;locomotor cases is an expected event,just like endocardiosis cases meds evetually fail and other symptoms develop.

i get the impression a significant number of the fail reported by owner is actually an unwillingness to say to the vet they can no longer afford an expensive treatment for their dog and a way of asking for somethimng mopre economic whilst talking to us the Professional, in quite a few cases they express their financial situation and releif something they have to pay less for at the reception desc after. i dont have a control study but the same is happening with a few of our other high cost treatments and both medication purchases and attendance for these treatments ahave clustered arround payday so much so that we have had to adjust staff rota. This might not be so overt in high insurance uptake areas or practises or more affluent areas . here i guess those who want to and still can access the range of prestige practises availible probably dont present this as often as those whoour sustainability depends on .

Its also the time of year where chronic locomotor problems present and decline most again maybe not so overt in warmer southern climes that see more daylight ?

RE: Are you seeing cases where Librela has stopped working?

Rob Loxley — Mon, 12 Feb 2024 22:09:30 GMT

[quote userid="8958" url="~/f/clinical-questions/30893/are-you-seeing-cases-where-librela-has-stopped-working/243707#243707"]It’s not easy to nail this to Librela as it you are dealing with dogs in decline[/quote]

Maybe I should have asked if everyone is reporting these suspect adverse events?!

RE: Are you seeing cases where Librela has stopped working?

David Mills — Mon, 12 Feb 2024 15:04:16 GMT

Prediction time.

Librela is heading for a cliff edge.

There is data on dogs treated with nsaids some of which will develop CDRM.

There are dogs on Librela a certain percentage of which seems to be developing CDRM type symptoms.

A simple incidence study (VetCompass maybe?) would probably help give an answer.

RE: Are you seeing cases where Librela has stopped working?

Neil Wheadon — Mon, 12 Feb 2024 09:02:34 GMT

It’s not easy to nail this to Librela as it you are dealing with dogs in decline. 2 observations from this thread

1) Clearly I’m not alone

2) I don’t start treatment on younger dogs and in that I mean under 10. Younger dogs would almost provide a control group?

Neil

RE: Are you seeing cases where Librela has stopped working?

Rob Loxley — Mon, 12 Feb 2024 08:23:35 GMT

Is everyone reporting all these adverse events?

RE: Are you seeing cases where Librela has stopped working?

Miriam Lodewyks — Sun, 11 Feb 2024 22:46:53 GMT

This is exactly what happened to my own dog and that of a vet friend. Worked for 7-8 months then went severely ataxic.
I discontinued and my dog gradually improved again.
I’ve been cautious of Librela since and would advise owners stop use at the first sign of neurological issues.

RE: Are you seeing cases where Librela has stopped working?

janine redman — Fri, 09 Feb 2024 22:03:49 GMT

There are a number of older dogs where they become paretic especially on the hind limbs . It is a,ways difficult to differentiate progression of arthritis versus neuropathy versus reduce sensation due to librela . Two of my own elderly dogs were on librela for a while . One became severely ataxic, incontinent and with reduced cognitive function. It took about 8 weeks for things to improve .

one is 16 and whilst was much happier initially also became more wobbly and confused after several injections. Again having withdrawn librela she has improved neurologically and also mentally over a couple of months but has become less comfortable.

i have many patients who do brilliantly but a number who are 2 years or so down the line where they are non painful now but weak . And several where I stop the medication because although the owners want to continue I feel the benefit has waned and I look at alternatives.

it does treat pain very well but definitely seems to increase incontinence, affects thirst and can exacerbate neurological dysfunction in my experience. I am closely watching my patients and have an advantage in a 1.5 vet practice where I have known many of patients all their lives and perhaps can pick up subtle changes .

RE: Are you seeing cases where Librela has stopped working?

Kate Richardson — Fri, 09 Feb 2024 17:03:05 GMT

I can't speak for Librela but I have a number of cats who were doing well on Solensia then it stopped lasting the full month- spoke to Zoetis, they advised increasing the dose (as the 7mg vial covers a range of weights, dose range 1-2.8mg/kg) so have a few cats on 1.5-2mls every month, one is even on 2.5mls. Needless to say these are insured cats. But it has worked well with increasing the dose and still being effective

Is the Librela dosing the same?

RE: Are you seeing cases where Librela has stopped working?

Richard Carter — Fri, 09 Feb 2024 14:44:27 GMT

Yes to the query about losing efficacy- it’s a biological product and as already mentioned, can provoke an immune response.

It also has no effect on arthritic damage, synovial production or preventing ongoing local oa changes so all the pathology remains unchecked

RE: Are you seeing cases where Librela has stopped working?

cairncross — Thu, 08 Feb 2024 16:50:11 GMT

yes but i suspect in many cases it is affordability and not willing to say they cannot meet the costs , hoping a more economic option will be offered.

RE: Are you seeing cases where Librela has stopped working?

Lucy Fleming — Wed, 07 Feb 2024 11:16:00 GMT

The datasheet does mention "The veterinary medicinal product may induce transient or persistent anti-drug antibodies. The induction of such antibodies is uncommon and may have no effect or may result in a decrease in efficacy in animals that responded to treatment previously" which might be one of the reasons for this (as well as, like you say, natural disease progression).

I'm fairly sure I've heard anecdotal stories of pets being given a "break" from librela for a few months and then efficacy returning when treatment was restarted, though I guess this couldn't be guaranteed.

It does seem like the other impacts of NGF are perhaps more wide-ranging and not sufficiently well understood to be certain we won't see unintended negative effects. Effects on foetal development potentially significant for some staff due to the risk of self-injection, but probably not that relevant for most of our patients if not intended for breeding, but that's not to say there may not be other significantly protective effects of NGF in some areas. It feels a little comparable to NSAIDs, and beneficial effects of cox-1 v inflammatory effects of cox-2 (to vastly over simplify)

RE: Are you seeing cases where Librela has stopped working?

Clive Ansell — Wed, 07 Feb 2024 06:55:16 GMT

Yes. I wouldn't say I've had a steady stream, but there have been a few.

I had one yesterday, elderly cocker spaniel been on Librela and Pardale-v for ages, but owner now reports not doing so well. He did have a fall on Boxing day and has been much worse since. So how much is it Librela being less effective, or natural disease progression, or an injury related flare up I don't know?

I'm cautious about Librela. I know it is peddled as a wonder drug, but I have my doubts it is entirely benign. A monoclonal antibody that knocks out nerve growth factor, so what other nerves could be afected , I don't know. Contraindications in the data sheet regarding the possible effects on a foetus.