Arthritis pain control

Another update.

Still on Chondroprotect, however it seemed to wane a bit.
Was supplementing Carprofen for quite a while, however considering studies indicating Meloxicam being a better Cox-2 inhibitor we switched him to that at refill time.
It did seem to work somewhat better, and the dosage for his large size is 1/4 of a 3mg tablet. It is definitely worth the extra $$ to go with the liquid suspension product.
After a couple of months though, noticed he seemed to be drinking a fair bit more water. Since that is a Black Box warning sign, discussed options with our vet and have moved on to Librela.
"Librela is the first and only monthly injectable anti-nerve growth factor (NGF) monoclonal antibody (mAb) therapy for dogs with osteoarthritis (OA) pain."
As it is a monoclonal antibody and not a metabolized drug, there should be few/no liver or kidney issues; which is what has been observed for several years in EU.
Its been 5-6 weeks+ since injection, and it definately appears to be superior to Chondroprotect (which isn't marketed as a pain killer), and has to be at least equal or better than daily pain meds.

While still reticent to sit, jump in the car or climb stairs, he usually will without obvious discomfort.
Just yesterday got some new treats and he was happy to sit, then down, then roll-over.
No problems running after squirrels off-leash at the empty park, playing kickball in our long hallway, etc.

He still has a problem with his right front leg, where he will dip down occasionally, however I can never find any obvious pain or soreness when massaging or manipulating pad, wrist, elbow or shoulder joint. While he doesn't limp or have an affected gait, and its probably arthritis, has anyone experienced similar and might it be a ligament or tendon tear?

Well, at a minimum this seems to be a safer option than most pain meds, however rather expensive for a 4/6/8 week shot regimen.
Not sure its readily available outside an actual office visit.

 

FYI, please do NOT take my initial thumbs-up for Librella as anything more than a single anecdote.
While Boots seemed to do well after the first shot, the more I dug around the more negative reports I started finding in a lot of UK forums.

The article below is a Vet oriented piece that partially explains the situation, and admittedly seems to be giving its members/Vets facing the public, 'Talking Points'.
https://www.dvm360.com/view/animal-health-company-assures-veterinarians-that-oa-drugs-are-safe

This article seems more focused on providing us with more actual explanation and data by which to make an informed decision.
https://www.dogsnaturallymagazine.com/librela-berensa-wonder-drug-or-disaster-in-the-making/

 

Glad it was useful.

I also should say, I believe this went through a lot of testing and I'm not trying to imply they hid information or such. A lot of people have had frankly remarkable success with it.
This just came out a week+ ago: https://www.washingtonpost.com/wellness/2024/04/20/librela-dog-arthritis-drug-side-effects/

I would obviously be careful, however hundred of thousands of dogs seem be using it well.
It sounds like the FDA is officially signaling it is currently reviewing reports.
From my experience in the bio-tech field, any time the FDA even looks in your direction it is almost impossible to hide much. So if possible I'd wait for a while, or perhaps they will come out with some sort of micro-shot test they can administer and then check blood markers.

Librella works by binding to natural occurring Nerve Growth Factor, which is mostly used in adult dogs for pain and inflammation signaling. Thats good, but everything in the body has multiple uses, cascade sequences dependent upon other molecules/markers such that sometime blocking one thing inadvertantly blocks something else. The brief research I did before getting Boots his first shot seemed pretty impressive and I'm not sure how/what they could have missed. I'm actually wondering if some of the dogs being injured actually have an existing issue that just has become pronounced enough to be known, and Librella binding to and blocking NGF simply exacerbates the condition.

 

Yes, that good to hear and agree.

I'm also thinking of trying the CBD route, as the Meloxicam seems to have waned or he's gotten worse.

 

Thats funny, because we are doing just that.

Unfortunately, WalmartPetRX close a while back and they were insanely economical.
I think with their 1st Auto-ship discount we got 150 carprofen for like $38, 100mg.
We cancelled and then my wife did similar with the Meloxicam at a crazy price.
She's in CA visiting family now, and reports the best price we can find at Costco with 120q 100mg $49.

I've got to do some more research on CBD again, as if I remember there are a multitude of molecules within the CBD family so its probably best to get one of the pain specific sub-types.

Also hard to know what to believe when you read this recent work:
https://www.bath.ac.uk/announcement...-and-are-potentially-harmful-new-study-finds/

Then you read this:
https://pubmed.ncbi.nlm.nih.gov/37953193/

This one though is very good, and the Safety section is also informative and a Must Read insofar as it appears as thought even 'safe' CBD has downside (actually discussed further above the safety section) and you really want to know the purity/%CBD in your product and the dosing really needs to be medicine like as there are negative effects possible/probable if one is assuming its safe/natural.

"Some studies showed promising evidence to support the safety of CBD. A review of 16 RCTs conducted by Mücke et al. in 1750 adult participants with neuropathic pain showed that cannabis-based medicine might help achieve >50% pain relief (primary outcome) compared with placebo [16].
It also increases nervous system adverse reactions, including psychiatric disorders, in 17% of participants"

Note- Its confusing as the start of the section indicate studies regarding CBD, and in that section we have the adverse/psychiatric disorders found at 17%, but the sentence above is talking about 'cannibis-based medicine' which is a generic description usually used to indicate CBD-alone, and THC/THC & CBD combined products.

I think starting at a lower than suggested dose, and keeping that for a good while like a week at least would be the least risky way to test.