Librela: A Breakthrough for Arthritis Pain in Dogs

Osteoarthritis affects 50% of large-breed adult dogs. While various pain medications are available, a new option, Librela, offers a more targeted approach to blocking pain. Here’s a look at how Librela works, which dogs it suits best, and its potential side effects.

To understand how Librela works, we first need a basic understanding of how pain signals are transmitted to the brain. Key components in the pain pathway, like neurotransmitters, play a crucial role in this process. For example, Nerve Growth Factor (NGF) is essential for the brain to perceive pain.

Dr. Elizabeth Benson founded Paws into Grace with a vision to provide pets and their families with a peaceful and meaningful final experience together.

Nerve Growth Factor is a protein that starts a pain signal. We also need axons, which we can think of as wires passing a message to the brain. These axons run from parts of the body, like inflamed joints, to the spinal cord and even from one part of the brain to another and back down to a joint. The axons, acting as wires, transmit a pain signal. Neurotransmitters like Nerve Growth Factor along the way can amplify or dampen the pain signal. Nerve Growth Factor binds to a receptor, starting the pain signal along the axons to the brain. Nerve Growth Factor is the ignition key to start the signal. It is also needed to amplify the signal, making it stronger. I think of NGF as gasoline added to fire, turning a little spark of pain into a full bonfire.

The injection Librela is an anti-Nerve Growth Factor treatment. It works by binding to NGF, reducing its effectiveness in transmitting pain signals. Think of it as an “assassin for hire” that targets NGF, preventing it from easily sending pain signals to the brain. In essence, Librela neutralizes and blocks NGF, dampening the pain pathway.

Who should receive the Anti-Nerve Growth Factor treatment Librela, and who should avoid it? The medication is approved only for dogs with osteoarthritis and has not been approved for postoperative pain or pain from diseases like bone cancer. However, there is a strong case for considering its use in conditions like bone cancer or osteosarcoma. Caution is advised for dogs with neurological diseases, and Librela should not be prescribed to dogs with hindlimb weakness or poor coordination. Dogs with underlying intervertebral disc disease, spinal cord inflammation, or degenerative myelopathy should also avoid Librela, as it appears to worsen symptoms for reasons not yet fully understood.

Are there side effects? The most common side effects of Librela are allergic reactions (which can sometimes be serious), higher kidney levels, and urinary tract infections. Also, increased kidney values and urinary tract infections.

Vets have reported cases where dogs’ symptoms worsen rapidly, particularly in those with existing nerve issues. For example, a dog with slight weakness in its back legs might suddenly lose bladder control, or its symptoms could significantly worsen. This is why Librela should not be used in dogs with pre-existing nerve conditions.

How well does Librela work? Research shows most dogs took at least 1 month to have dramatic pain relief and better mobility. If given for at least 3 months, about half of dogs have improved quality of life. It has been reported that many patients on NSAIDS/ anti-inflammatory drugs have been completely taken off after starting Librela with good pain control.

For me, jury is still out on this drug.

Would I consider it for my Hospice Comfort Care patients or even Osteosarcoma? Absolutely, Yes.

Are there patients that I would not prescribe it to? Absolutely, yes. I wouldn’t recommend this drug for any dog with existing neurological issues. That includes dogs with conditions like intervertebral disc disease, degenerative myelopathy, or any dog with an abnormal neurological exam. I’d also ensure that every family fully understands the potential side effects, choosing candidates carefully until we know more about its effects. That said, it does have a place in my toolkit for certain patients.

Dr. Benson was quoted in Newsweek for her expert opinion on this new medication that may transform the lives of aging pets. Read the article here: Owner Shows Incredible Difference Injection Made to Her Senior Dog’s Life.

Dr. Benson started Paws into Grace in 2007. She wanted to give pets and their parents a beautiful last encounter that didn't have to be in an unfamiliar office where pets were often frightened. The empathy she shows each family creates a lasting impression on them. In her free time, Dr. Benson enjoys running and spending time with her family, dogs, cats, and chickens.

  

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My absolute love Dante had heart failure three months ago. After having him on many medications to help him, his enthusiasm and appetite declined last couple of days. He was in pain and we decided to help him go to heaven rather than torturing him... read more

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I wanted to thank you for sending Dr. Brown to euthanize our beloved Myleigh on March 4, 2021. She was compassionate and accommodating, she explained every step of the procedure, and gave us some alone time with Myleigh after she sedated her, but... read more

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I can't recommend them enough. I had to say goodbye to my 21 year old cat companion. I read the reviews here on Yelp and chose Paws Into Grace and they made an unbearable situation not worse - from the people on the phone to the amazing doctor who came out to the house. She was so understanding and supportive. They were all so helpful, understanding and nice. My girl got to stay at home and say goodbye in the backyard (a hummingbird flew over and it seemed like a good sign too). So glad I didn't have to take her to a cold vet office.

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My absolute love Dante had heart failure three months ago. After having him on many medications to help him, his enthusiasm and appetite declined last couple of days. He was in pain and we decided to help him go to heaven rather than torturing him with more medications which would make him even more miserable. I called and spoke to a very kind lady who was patient as I cried through making an appointment. We made an appointment for 1:30pm. Dr. Toni arrived. She was very kind, explained everything to us and gave us the time to be with our boy after the first shot. He wasn't relaxing enough so she gave him a second shot. We stayed with him throughout the entire process and I carried him to her car in the end. It was a very difficult decision but knowing that our boy is not in pain, gives us some peace. We are thankful to Dr. Toni for her kindness and compassion. They will arrange the cremation for us. Since we are in a pandemic, we had our masks on and said goodbye to our boy in our garden.

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