The U.S. Food and Drug Administration (FDA) has issued a warning regarding Librela, a popular medication for canine osteoarthritis, following reports of serious adverse reactions in treated dogs. According to FDA data, 3,674 dogs have experienced adverse reactions to the drug as of April 2024, with 458 reported deaths.
Librela, manufactured by Zoetis, was launched in the United States in 2023 and has since been administered to more than one million dogs. The monthly injection works by blocking nerve growth factor to control pain and improve mobility in dogs suffering from osteoarthritis.
Mounting Concerns Among Pet Owners
The FDA warning has amplified growing concerns among pet owners who have witnessed severe reactions in their animals. Rich Pearson from Holden, Missouri, lost his six-year-old border collie mix, Rigby, just ten days after administering the first dose of Librela.
"Over the span of a few days, he started to get a rash, and he didn't have a great appetite," Pearson recounted. Despite veterinary advice to continue the treatment for a full month, Rigby's condition deteriorated rapidly. "He had stopped eating completely, stopped drinking water," Pearson said, ultimately leading to the difficult decision to euthanize his companion.
Pearson's experience is not isolated. The significant number of adverse event reports submitted to the FDA suggests a pattern that warranted regulatory attention, leading to the official warning issued three months after Rigby's death.
Expert Perspectives on Librela's Safety Profile
Dr. Sam Franklin, a board-certified orthopedic surgeon with Kansas City Canine Orthopedics, believes the concerns about Librela are likely founded. "My suspicion is that the concerns are probably founded and that the FDA issued its letter based upon enough reports," Franklin stated.
However, he also acknowledged the manufacturer's potential counterargument: "The manufacturer might point out that, 'Hey, there have been tens of millions of doses prescribed for dogs in the United States and Europe, if these complications were very frequent and severe, we would have recognized or heard of them sooner.'"
When asked directly about the drug's safety, Franklin offered a measured response: "I can't say, 'Yes, it's safe,' but that's true of just about everything. There is risk with absolutely everything."
Clinical Recommendations for Veterinarians and Pet Owners
Dr. Franklin recommends that pet owners and veterinarians consider three key questions before initiating Librela treatment:
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Specific Diagnosis: "Investigate why your dog is developing the osteoarthritis and try and figure out what the underlying explanation or diagnosis is," Franklin advised. "Knowing the details of the joint and the condition is relevant to whether or not Librela's going to be one of the treatments that's potentially used."
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Alternative Treatments: "There are many nonsurgical management options, and my top choices are weight loss, moderate daily activity, optimal diet, oral NSAIDs, and potentially injections into the joint," he explained.
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Treatment Efficacy: "Work to get a diagnosis to fully understand what is ailing your dog and what your numerous options are for managing that," Franklin said. "Then you want to weigh the pros and cons and then concerns/risks associated with Librela."
Manufacturer Response and Label Updates
Zoetis has stated that it remains "confident in the safety and effectiveness of Librela" despite the mounting concerns. In February, following the FDA's warning, the company updated Librela's label to include information about potential adverse reactions.
Reports suggest that Zoetis has attempted to mitigate negative publicity by offering compensation to affected pet owners. Pearson claims the company offered to pay his veterinary bills in exchange for signing a non-disclosure agreement, which he declined.
"We don't have kids, this is our family, this is what we've built on," Pearson explained. "For us, there's no amount of money that would be able to reflect or replace the opportunity to save lives."
Legal Implications
The controversy has now entered the legal arena, with Pearson joining a class action lawsuit against Zoetis regarding Librela. This legal action may force greater transparency about the drug's safety profile and potentially lead to additional regulatory scrutiny.
Balancing Benefits and Risks
Canine osteoarthritis affects millions of dogs worldwide, causing significant pain and reduced quality of life. Before Librela's introduction, treatment options primarily consisted of pain management through NSAIDs, physical therapy, and lifestyle modifications.
Librela represented a significant advancement in treatment options with its monthly administration schedule and targeted mechanism of action. However, the recent safety concerns highlight the importance of careful patient selection and thorough risk-benefit analysis before prescribing any medication.
Veterinarians are now advised to discuss these emerging safety concerns with pet owners and to closely monitor patients receiving Librela for any signs of adverse reactions, particularly during the initial treatment period.
