“To date, there are no specific disease modifying anti-osteoarthritic treatments. Current management of patients with osteoarthritis aims to improve patient and societal outcomes by reducing symptoms and improving function. Clinical guidelines broadly recommend the provision of effective and individualised information, combined with non-pharmacological and pharmacological interventions, and when these are insufficient, surgery.”
Kloppenburg M., et al. “Osteoarthritis” Lancet 2025
Posted in dog care, dog quotes, Dogs
Tagged canine arthritis, dog massage, journal, Lancet, non-pharmacological interventions, osteoarthritis
This article was published on 9 May 2025 in the journal Frontiers in Veterinary Science and its rate of sharing and views shows that it is gaining a lot of interest. I am copying the article here, with attribution, to ensure that dog owners make an informed choice when the drug (known as Beransa in our local market) is recommended.
There is clinical evidence that osteoarthritis worsens at an increased rate when using the medication.
One of the authors, Dr Mike Farrell, has also published this lecture to veterinary professionals, to explain the trial process and the history of adverse effects of this class of drugs.
I’m a science geek and I like to understand clinical trial information and the defensibility of clinical trial information. I encourage my clients to be knowledgeable and to ask the right questions of their vet when all medications are prescribed for their dogs. This post, like others about this drug, is shared to inform dog owners.
Objectives: To conduct a specialist-led disproportionality analysis of musculoskeletal adverse event reports (MSAERs) in dogs treated with bedinvetmab (Librela™) compared to six comparator drugs with the same indication. Furthermore, to report the findings from a subset of dogs whose adverse event (AE) data underwent independent adjudication by an expert panel.
Study design: Case–control study and case series analysis.
Sample population: The European Medicines Agency’s EudraVigilance database (2004–2024) and 19 client-owned dogs.
Methods: An EBVS® Veterinary Specialist in Surgery individually reviewed all MSAERs to Librela™, Rimadyl®, Metacam®, Previcox®, Onsior®, Galliprant®, and Daxocox® (2004–2024). The primary null hypothesis was that Librela’s MSAER rate would not exceed that of comparator drugs by more than 50%. The secondary hypothesis was that MSAER would surge and taper following the launch of new drugs.
Results: The disproportionality analysis did not support the hypotheses. Ligament/tendon injury, polyarthritis, fracture, musculoskeletal neoplasia, and septic arthritis were reported ~9-times more frequently in Librela-treated dogs than the combined total of dogs treated with the comparator drugs. A review of 19 suspected musculoskeletal adverse events (MSAEs) by an 18-member expert panel unanimously concluded a strong suspicion of a causal association between bedinvetmab and accelerated joint destruction.
Conclusion: This study supports recent FDA analyses by demonstrating an increased reporting rate of musculoskeletal adverse events in dogs treated with Librela. Further investigation and close clinical monitoring of treated dogs are warranted.
Impact: Our findings should serve as a catalyst for large-scale investigations into bedinvetmab’s risks and pharmacovigilance.
Osteoarthritis (OA) is the most prevalent chronic pain condition in companion animals, and is a significant contributor to reduced quality of life and premature death (1). Although a diverse array of therapeutic approaches are currently available, all possess limitations, including suboptimal efficacy and the potential for severe adverse reactions. Chronic pain management is challenged by the trade-off between safety and efficacy. Analgesic drugs that provide significant pain relief can carry a higher risk of adverse reactions than safer, less effective options like glucosamine-chondroitin joint supplements (2). This therapeutic dilemma is complicated by differing risk perceptions between veterinarians and caregivers. Veterinarians, due to their medical training, may be more comfortable with the risks associated with prescription analgesics, whereas caregivers may be more hesitant, sometimes declining or limiting their use even when deemed necessary by the veterinarian (3). This disconnect is underscored by a 2018 study revealing that 22% of dogs for whom analgesics were recommended by their veterinarians did not receive them (4).
Development of new therapies offering enhanced safety and efficacy can help bridge the gap between veterinary recommendations and caregiver acceptance. Bedinvetmab (Librela™), a monoclonal antibody (mAb) targeting nerve growth factor (NGF), represents a significant advancement in canine osteoarthritis (OA) pain management. Following its approval by the European Commission in November 2020, it became the first mAb authorized for this indication. The Food and Drug Administration (FDA) granted U.S. marketing authorization 2.5 years later, and the Australian Pesticides and Veterinary Medicines Authority subsequently registered the same drug as Beransa™.
While these regulatory approvals underscored worldwide confidence in veterinary mAbs, their human equivalent were associated with substantial safety concerns. Specifically, NGF modulates bone and cartilage turnover (5), and its inhibition is linked to accelerated joint degeneration in humans (6, 7). This was evidenced in 2012, when clinical trials of anti-NGF mAbs (aNGFmAbs) revealed rapidly progressive osteoarthritis (RPOA) (8), leading the FDA to impose a two-year clinical trial hold and mandate a risk evaluation and mitigation strategy (REMS) post-hold. However, even with stringent screening, low dosing, and NSAID prohibition after the REMS was implemented, RPOA risk persisted (9–11). While the exact mechanism is still under investigation, human clinical trials did not support the hypothesis that RPOA is caused by overuse of weight-bearing joints (7, 10).
Post-marketing pharmacovigilance is crucial for continuously monitoring a drug’s safety and efficacy after it enters the market, as clinical trials cannot capture the full spectrum of potential adverse reactions. It involves a combination of voluntary reporting of adverse drug reactions (ADRs) by healthcare professionals and the public, and proactive surveillance programs, including government-funded, industry-sponsored, and independent research. Their findings inform regulatory decisions, which can range from label updates and limited use restrictions to, in rare cases, market withdrawal if the risks outweigh the benefits (12).
When an animal exhibits unexpected clinical signs following drug administration, differentiating these effects from the underlying disease or a new unrelated condition can be complex. Nevertheless, prompt identification of potential causal relationships is paramount for ensuring patient safety. The thalidomide tragedy exemplifies the critical importance of rigorous pre-clinical and post-marketing drug safety surveillance. Insufficient testing and a lack of robust post-marketing surveillance systems failed to identify the teratogenic potential of thalidomide (13). This resulted in widespread use of the drug leading to severe birth defects in thousands of children, highlighting the potentially devastating consequences of delayed recognition of drug-related adverse events.
In December 2024, the FDA issued an open letter to veterinarians, alerting them to neurological and musculoskeletal safety signals identified during their post-marketing surveillance of Librela (14). The FDA’s Center for Veterinary Medicine (CVM) employed an algorithmic approach to evaluate ADRs. Their approach, incorporating disproportionality analysis, statistically assessed the frequency of reported adverse events (AEs) in dogs receiving Librela compared to those treated with other OA medications. The FDA’s analysis identified 18 distinct safety signals in dogs administered Librela, encompassing neurological events, urinary problems, and musculoskeletal disorders (14). Notably, the FDA observed a disproportionately elevated reporting rate of “lameness” in dogs receiving Librela. In response, the Center for Veterinary Medicine (CVM) advised veterinarians to proactively inform pet owners about these potential adverse reactions (14).
The CVM emphasized that their objective was to generate hypotheses, acknowledging the inherent limitations of establishing definitive causality (14). They noted that AE reporting systems are subject to various biases, including underreporting, reporting biases influenced by [social] media attention, and confounding factors such as concomitant medications. Furthermore, the CVM’s reliance on algorithmic analyses of secondary data, without the benefit of expert clinical interpretation, introduces additional diagnostic uncertainty (15). To address this limitation, we employed a two-pronged approach. Firstly, we conducted a specialist-led disproportionality analysis of musculoskeletal adverse event reports (MSAERs) to expand upon the CVM’s work. This analysis tested the null hypothesis that Librela’s MSAER rate would not exceed that of six comparator drugs with the same indication by more than 50%. Secondly, we report the findings from a subset of dogs whose AE data were subjected to independent adjudication by an expert panel and subsequently submitted to the European Medicines Agency (EMA).
A detailed description of the EudraVigilance database (EVD) analysis is provided in Supplementary Video 1. Briefly, accurate identification of clinically relevant musculoskeletal adverse events (MSAEs) required a thorough understanding of the pharmacovigilance system’s information flow (Figure 1), and the limitations inherent in the system. Specifically, diagnostic terms submitted by primary reporters are only published if they are listed in the Veterinary Dictionary for Drug Regulatory Activities (VeDDRA). Otherwise, the Marketing Authorization Holder (MAH; Zoetis, Louvain-la-Neuve, Belgium) selects a diagnostic term from a predefined list including clinical signs (e.g., lameness), non-specific diagnoses (e.g., arthritis), and specific diagnoses (e.g., ligament rupture) (16). At the time of analysis, VeDDRA contained 113 musculoskeletal and 313 neurological AE diagnoses (i.e., low-level terms, LLTs) (16). Many LLTs exhibit clinically relevant overlap (Table 1). For example, “limb weakness” (a musculoskeletal LLT) may indicate a neurological problem, while “collapse of leg” (a neurological LLT) might describe an orthopedic AE. With over 35,000 possible combinations of musculoskeletal and neurological LLTs, a simple algorithmic approach was not considered feasible.
To ensure consistency and account for the complex clinical judgments required for data interpretation, a single EBVS® Specialist in Surgery (Author 1) reviewed musculoskeletal adverse event reports (MSAERs) logged within the European Medicines Agency’s (EMA) EudraVigilance database (EVD) from its 2004 inception to December 31, 2024. A descriptive disproportionality analysis was used to compare the incidence of MSAERs associated with Librela to those of six other veterinary analgesics: Rimadyl®, Metacam®, Previcox®, Onsior®, Galliprant®, and Daxocox®. This analysis aimed to identify any potential temporal trends in MSAER reporting, particularly following the introduction of new medications. All adverse event reports (AERs) are filed in the EVD under trade names; therefore, trade names are used consistently throughout this manuscript.
This study utilized a retrospective, case series design. Case recruitment was initiated by Author 1 following the observation of a suspected case of RPOA in a dog receiving Librela. This case was shared on a specialist veterinary forum (17). Subsequently, over an 11-month period, multiple clinicians who subscribed to the forum contacted Author 1 to share concerns regarding serious MSAEs in dogs treated with Librela. Based on these communications, an independent working group was formed comprising clinicians with firsthand experience with MSAEs (see below). The primary objective was to investigate a potential association between Librela administration and the observed pathology. Given the lack of prior records of RPOA in dogs, the working group sought advice from an expert in human neuro-osteoarthropathy (Author 2) and two EBVS® Specialists in Diagnostic Imaging with published expertise in musculoskeletal imaging (Authors 3 and 4).
Twenty-three suspected musculoskeletal adverse events (MSAEs) were independently reviewed by nine investigators with a combined 128 years of experience in referral practice (Authors 1, 5, 6, 7, 9, 11, 14, 15, 16). Clinical data from each case, including signalment, clinical signs, Librela dosing information, concurrent medications, treatment outcomes, and relevant diagnostic test results (radiographs, CT scans, synovial fluid analysis, histopathology), were evaluated. Four cases were excluded from further analysis due to incomplete data or insufficient evidence to support a causal relationship. Twelve MSAERs had already been filed in the EVD, and retrospective reports were filed for the remaining cases at this time.
The independent adjudication panel comprised 12 veterinary orthopedic surgeons, an orthopedic consultant specializing in human neuro-osteoarthropathy, two veterinary diagnostic imaging specialists, two veterinary anesthetists, and a cancer researcher with expertise in monoclonal receptor-based therapeutics. The adjudication panel demonstrated collective expertise including 157 relevant peer-reviewed publications spanning monoclonal antibodies, neuropathic arthropathy, canine osteoarthritis (OA), pathological fractures, and humeral intracondylar fissure (HIF).
Transcripts from the 2012 and 2021 Arthritis Advisory Committee (AAC) and Drug Safety and Risk Management Advisory Committee Meetings were reviewed. Our analysis focused on their joint safety review of humanized anti-nerve growth factor monoclonal antibodies (aNGFmAbs) (8–10). The following limitations in clinical trials used to define human RPOA were acknowledged:
1. Inconsistent baseline imaging: Humans enrolled in low-back pain aNGFmAb clinical trials who developed RPOA did not undergo baseline radiographic imaging of the affected joint (s) before starting treatment (8, 18).
2. Nonspecific terminology: The definition of human RPOA included joint pathology “falling well outside the natural history of OA” (8). Notably, this criterion lacked a specific definition of the “natural history of OA” and did not reference a control group with typical OA progression.
3. Inapplicability of the human definition: The specific term “RPOA” was not adopted for our case adjudication due to its reliance on measurements of large human joints using standing radiographs or MRI (11).
Nineteen dogs with suspected MSAEs following bedinvetmab treatment were independently evaluated by Authors 3 and 4. Suspected drug-related AEs were defined according to the AAC’s methodology as joint pathology “falling well outside the natural history of OA” (8). This included pathological fractures or luxations in osteoarthritic joints, and subchondral osteolysis in the absence of clinical evidence of septic or immune-mediated arthritis. Inter-rater agreement for the two diagnostic imaging specialists was tested using the Fleiss κ coefficient (19).
Diagnostic images were formatted and annotated by Authors 1 and 3. Subsequently, all 18 experts independently reviewed the annotated images, emulating standard clinical practice. The entire cohort of 19 cases was evaluated collectively by the adjudication panel to determine potential drug causality, rather than assessing each case individually, mirroring the AAC’s 2012 protocol (8). Readers can review the cases by watching Supplementary Video 2.
A three-tiered system was used to describe a potential causal relationship between bedinvetmab treatment and MSAEs. Outcomes explicitly implying a known causal link (e.g., “definitely related”) were avoided to reflect the inherent uncertainty of this assessment. Instead, the experts described their personal judgment as “very suspicious,” “suspicious,” or “insufficient evidence” of a potential causal relationship.
Translation errors were identified by comparing MSAERs submitted by attending veterinarians with corresponding reports filed by the MAH. A clinically relevant discrepancy between the reports was considered a translation error.
A total of 4,746 MSAERs were identified between May 20, 2021 (3 months after Librela’s European release) and December 31, 2024. Following the exclusion of 457 comparator medication reports which specified co-administration of Librela, 4,289 MSAERs remained. Of these, 3,755 (87.5%) were attributed to Librela. The majority of MSAERs (3,411, 79.5%) were excluded due to confounding neurological and/or systemic/neoplastic diagnoses (Supplementary Video 1), resulting in a final cohort of 878 eligible MSAERs for analysis, with 789 (90%) attributed to Librela (Supplementary Table S1). Most primary reports to Librela (88%) were submitted by veterinarians and other healthcare professionals (Figure 1).
Ligament/tendon injury, polyarthritis, fracture, musculoskeletal neoplasia, and septic arthritis were reported ~9-times more frequently in Librela-treated dogs than the combined total of dogs treated with the comparator medications (Figure 2). Furthermore, accumulated MSAERs for Librela over 45 months exceeded those of the highest-ranking NSAID (Rimadyl) by ~20-fold and surpassed the combined accumulated MSAERs of all comparator drugs over 240 months by ~3-fold (Figure 3). These findings did not support the null hypothesis that Librela’s MSAER rate would not exceed that of comparator drugs by more than 50%. Moreover, the secondary hypothesis that MSAER would surge and taper following the launch of new drugs was not supported (Figure 3).
The most frequent diagnostic terms selected by the MAH were “arthritis” or associated clinical signs (e.g., “lameness”, “joint pain”, “difficulty climbing stairs”), encompassing 530 cases (67%) (Figure 4). Of these, the MAH filed 442 reports (83.4%) as “not serious”. The remaining 259 ADRs included ligament injuries, limb collapse, polyarthritis, bone cancer, and fractures. Among these, the MAH filed 138 reports (52.3%) as “not serious”.
The most frequently reported outcome was “unknown” (310 dogs; 39%). Of the remaining dogs, 177 (22%) experienced AEs that were reported as “recovered/resolving/normal”; 229 (29%) were filed as “ongoing”; 15 (2%) “recovered with sequelae”; and 63 dogs (8%) died or had been euthanized.
Clinical and radiographic characteristics are summarized in Table 2 and Figures 5–13. Mean ± SD number of Librela doses was 12.7 ± 9.5 (range 1–30), with a dose range of 0.4–0.76 mg/kg (mean 0.62 ± 0.08 mg/kg). Referral for investigation of suspected RPOA was made at least 6 months after Librela initiation in 13/19 cases. Eleven dogs (58%) received regular concurrent NSAIDs. The most frequently affected joint was the elbow (13/19 dogs, 68%), followed by the stifle and hock (two dogs each), and hip (one dog). Seven dogs (37%) sustained pathological fractures, and two (10.5%) had joint luxations. Two dogs with clinically normal hock joints before initiating Librela therapy developed severe non-index hock joint destruction after Librela treatment for elbow OA.
Histopathological examination of bone and synovial tissue from four dogs revealed no evidence of inflammatory arthropathy, tick-borne diseases, or neoplasia. A pathologist who was invited to compare their findings to those reported in a submitted article on human RPOA (20) commented that the pathological features were similar (21).
Interobserver agreement between diagnostic imaging specialists was substantial (κ = 0.68, 95% CI 0.4–0.97). Both specialists were very suspicious of a potential causal relationship between the observed pathology and Librela treatment in 68% of dogs (13/19). Furthermore, all 18 panelists (including the two diagnostic imagers) were very suspicious of a potential causal relationship between Librela treatment and the observed pathology.
Translation errors were identified in 9/19 cases (52%) (Table 2 and Supplementary Figures S1–S6). They included incorrect diagnoses (n = 5), severity (n = 5), and outcome (n = 5). Furthermore, the MAH reported two cases as “overdoses”, despite the administered dosages falling within the recommended range.
This study reveals a striking disparity in musculoskeletal adverse event reports to Librela compared to six comparator drugs. Ligament/tendon injuries, polyarthritis, fractures, musculoskeletal neoplasia, and septic arthritis were reported nine times more frequently in Librela-treated dogs. Worryingly, since its European release, Librela has accumulated 20 times more reports than the highest-ranking comparator drug (Rimadyl) and three times more than all comparator drugs combined over a 20-year period. Furthermore, independent expert review of a subset of cases strongly supported a causal association between Librela and accelerated joint destruction.
Librela experienced rapid market penetration following its 2021 European release. Zoetis recently reported global distribution exceeding 21 million doses, translating to an estimated average daily distribution of over 15,000 doses (22). This initial market success has been tempered by emerging concerns regarding bedinvetmab’s safety. These concerns have been amplified by various factors, including the FDA’s safety update (14), negative press coverage (23), the European Commission’s investigation into potential anticompetitive conduct by Zoetis (24), and the emergence of online communities disseminating safety concerns. This confluence of events has fostered a climate of apprehension and confusion. Addressing these concerns requires unbiased and rigorous post-marketing pharmacovigilance to evaluate this drug’s true risk–benefit profile.
Assessing the “expectedness” of adverse drug reactions (ADRs) is fundamental to effective pharmacovigilance. In causal relationship investigations, statisticians use Bayesian principles to evaluate reaction likelihood, considering plausibility and prior knowledge (15). The FDA’s ABON (Algorithm for Bayesian Onset of symptoms) links drug exposure to adverse events AEs (15). For example, when applied to NSAIDs, ABON incorporates prior knowledge of prostaglandin inhibition, its effect on gastrointestinal (GI) mucosal integrity, and the established link between NSAIDs and GI ulceration (25). Notably, NSAIDs can cause subclinical GI damage, undetectable without endoscopy (25). When clinical signs occur, vomiting and diarrhea are common manifestations (26). However, the FDA does not use sales-figure-based prevalence estimates, because they can dramatically underrepresent true incidence (15). For example, comparing carprofen’s AERs to drug sales suggests vomiting and diarrhea occur in <1/10,000 doses, falsely implying that common side-effects are “very rare” (27).
The NSAID analogy is valuable for three reasons. First, while prostaglandins safeguard gastrointestinal integrity, NGF plays a similar pivotal role in bone and cartilage repair (5). Second, serious subclinical cartilage and bone degeneration often precede clinical signs (28). Third, recent claims of bedinvetmab’s “rare” or “very rare” AEs (29) are based on similar methodology to the carprofen analysis described above. Given NGF’s diverse roles and prior evidence of RPOA, subchondral bone fractures, and atraumatic joint luxations in humans and animals (8, 11, 30–33), bedinvetmab-associated MSAEs are an expected consequence of NGF inhibition.
Bayesian analysis, while powerful, can be susceptible to subjective biases. This is exemplified by the FDA’s role in the opioid crisis. Despite acknowledging the inherent risk of opioid addiction, the agency over-relied on a five-sentence letter, disproportionately cited as evidence of low addiction rates with oral opioid therapy (34). The FDA’s subsequent mischaracterization of addiction risk as “minimal” was heavily criticized (34). Similarly, the hypothesis that RPOA is a uniquely human problem has faced significant criticism. Multiple experts have contested this claim (32, 35, 36), citing weak supporting data (37). Notably, the joint safety claims outlined in Librela’s datasheet (38) are based on radiographic assessment of five healthy beagles who received the recommended dose (37). This study reported “mild” cartilage erosion in two dogs, despite erosion being, by definition, a severe form of cartilage pathology. Furthermore, despite being invited to provide annotated images to clarify this discrepancy (36), Zoetis declined to do so (39).
Janssen (fulranumab), Pfizer (tanezumab), and Regeneron (fasinumab) self-reported accelerated joint degeneration in their pre-marketing human aNGFmab clinical trials (8). The FDA responded quickly and decisively, voting 21–0 to recognize RPOA as a side-effect of aNGFmAbs and mandating a sophisticated risk mitigation strategy for all subsequent trials (8). The scale of the precautions undertaken by these pharmaceutical companies is exemplified by Pfizer’s tanezumab program, which involved 18,000 patients and 50,000 radiographs analyzed by 250 experts (11).
When viewed in context, bedinvetmab’s limited pre-marketing clinical trials raise serious concerns. Only 89 dogs received more than three doses (40), and crucially, no radiographic screening for accelerated joint degeneration was conducted (40, 41). Unlike Janssen, Pfizer, and Regeneron, Zoetis was unable to self-report accelerated joint destruction due to the absence of radiographic investigations. Consequently, we must rely on post-marketing surveillance to determine whether companion animals experience the adverse joint pathology observed in humans and laboratory animals treated with aNGFmAbs.
We initially intended to publish only the 19 adjudicated cases as a case series. However, we recognized the potential for case examples of severe pathology to be dismissed as outliers—isolated events swamped by the widespread positive experiences reported with bedinvetmab. Given Librela’s popularity, this perspective would be understandable. However, this response would be analogous to assessing the risk of NSAID-induced gastrointestinal harm by comparing the incidence of perforating gastric ulcers with NSAID sales figures. It should be obvious that such an approach neglects the critical fact that NSAIDs can induce subclinical harm which is undetectable without inconvenient tests such as endoscopy. Crucially, unlike the gastrointestinal mucosa, which possesses significant regenerative capacity, cartilage damage, once incurred, is largely irreversible (42). This fundamental difference underscores the gravity of MSAEs associated with aNGFmAbs.
To complement the FDA’s Bayesian analyses, which collected data from May 2023 to March 2024, we employed a descriptive evaluation to 20 years of MSAER data. This approach was deemed complementary because the ABON algorithm primarily focuses on identifying ADRs occurring shortly after medication initiation, while MSAEs often exhibit a long latency period between drug administration and AE detection. This hypothesis is supported by the observation that most reactions in the FDA’s analysis occurred within the first week post-injection, whereas most human RPOA (9, 10) and 13/19 cases in our study manifested at least 6 months after treatment initiation.
A limitation of our descriptive analysis is the inherent subjectivity associated with expert judgment. To mitigate potential bias, the adjudication panel primarily comprised veterinarians with a shared interest in advancing pain management for companion animals. Importantly, none had financial ties to veterinary pharmaceutical companies. Having mitigated bias, and recognizing the inherent subjectivity in data analysis and interpretation, we prioritized data presentation to facilitate independent judgment by readers, regardless of their level of expertise. Another acknowledged limitation of our study pertains to the FDA’s guidance that AE signal detection should primarily serve as a hypothesis-generating tool. Accordingly, our exploratory study was designed to identify potential safety signals rather than provide a comprehensive safety profile. As such, it cannot address specific questions like the impact of NSAID co-administration on MSAER risk. However, we believe these findings offer valuable insights and will stimulate further investigation.
Our study highlights an important weakness in the current pharmacovigilance system: the lack of comprehensive terminology for accurately capturing serious AEs. The absence of RPOA as a diagnostic term in VeDDRA is of particular concern, potentially leading to a substantial underestimation of MSAERs. Without a specific term, these events may be misclassified as manifestations of the underlying condition being treated (e.g., “arthritis” or “lameness”), obscuring the true incidence and severity of ADRs. To address this deficiency and enhance data quality, we formally requested the addition of the term “RPOA” to VeDDRA (16). Our proposed definition, “joint pathology falling well outside the natural history of OA,” leverages the expertise and clinical judgment of reporting veterinarians with direct access to patient data.
An FDA panelist involved in the adjudication of humanized aNGFmAbs eloquently summarised our current belief: “All parties agree that the use of aNGFmabs is effective, but they are associated with a unique, rapidly progressing form of OA…and we can only speculate as to its causes (8).” In animals, just as in humans, the goal of effective pain management is paramount. However, we must also ensure that our therapeutic interventions do not inadvertently exacerbate the underlying condition. To uphold the highest standard of care for companion animals, we hope to apply the same rigorous scrutiny to veterinary mAbs as was employed in human healthcare.
The original contributions presented in the study are included in the article/Supplementary material.
MF: Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft, Writing – review & editing. FW: Formal analysis, Investigation, Writing – review & editing. IC: Formal analysis, Investigation, Methodology, Supervision, Writing – review & editing. GS: Formal analysis, Writing – review & editing. LC: Formal analysis, Resources, Writing – review & editing. RA: Formal analysis, Supervision, Writing – review & editing. DP: Formal analysis, Supervision, Writing – review & editing. RS: Formal analysis, Writing – review & editing. DV: Formal analysis, Writing – review & editing. MA-V: Formal analysis, Resources, Writing – review & editing. AP: Formal analysis, Writing – review & editing. RQ: Formal analysis, Writing – review & editing. JH: Formal analysis, Writing – review & editing. SC: Formal analysis, Writing – review & editing. CJ: Formal analysis, Writing – review & editing. MH: Formal analysis, Writing – review & editing. AM: Formal analysis, Writing – review & editing. MG: Formal analysis, Writing – review & editing.
The author(s) declare that no financial support was received for the research and/or publication of this article.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The authors declare that no Gen AI was used in the creation of this manuscript.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fvets.2025.1581490/full#supplementary-material
SUPPLEMENTARY VIDEO 1 | Demonstration of the EudraVigilance database MSAER search strategy. The database can be accessed at: https://www.adrreports.eu/vet/en/search.html# (Accessed September 18–23, 2024 and January 1–10, 2025).
SUPPLEMENTARY VIDEO 2 | Narrated slideshow used by the independent adjudication panel.
SUPPLEMENTARY TABLE S1 | 789 musculoskeletal adverse event reports to Librela (May 2021–December 2024).
SUPPLEMENTARY FIGURE S1 | Case 1—AER translation error. The attending specialist filed an AER specifying their suspicion of RPOA. The MAH filed a report with an incorrect diagnosis of septic arthritis.
SUPPLEMENTARY FIGURE S2 | Case 2—AER translation error. The MAH filed a report specifying “overdose” but the administered dose (0.6 mg/kg) was in the recommended range (38).
SUPPLEMENTARY FIGURE S3 | Case 4—AER translation error. A 9.3-year-old Labrador Retriever sustained a pathological elbow fracture. The attending specialist filed an AER to the VMD specifying their suspicion of RPOA. This report was shared with the MAH, who filed a report for non-serious “arthritis”, with a listed outcome of recovered/resolving.
SUPPLEMENTARY FIGURE S4 | Case 10—AER translation error. A 10-year-old GSD required hindlimb amputation to manage erosive tarsometatarsal OA. The attending specialist filed an AER to the VMD including the result of the histopathological analysis (which was consistent with RPOA). The MAH filed a report stating that the AE was recovered/resolving following “digit amputation”.
SUPPLEMENTARY FIGURE S5 | Case 11—AER translation error. The attending specialist filed an AER to the VMD specifying a diagnosis of ongoing RPOA. The MAH filed a report for non-serious arthritis which was recovered/resolving.
SUPPLEMENTARY FIGURE S6 | Case 12—AER translation error. The attending specialist filed an AER to the VMD specifying a diagnosis of severe RPOA. The MAH filed a report for a non-severe bone and joint disorder which was recovered/resolving. The MAH filed a report specifying “overdose” but the administered dose (0.7 mg/kg) was in the recommended range (38).
SUPPLEMENTARY FIGURE S7 | Case 13—AER translation error. The attending specialist filed an AER specifying their suspicion of RPOA. The MAH filed a report with an erroneous diagnosis of osteosarcoma.
SUPPLEMENTARY FIGURE S8 | Case 15—AER translation error. A 9.5-year-old English Bull Terrier developed erosive arthritis in previously normal hock joints. The MAH filed a report with a diagnosis of non-serious swollen joint which was recovered/resolving.
SUPPLEMENTARY FIGURE S9 | Case 18—AER translation error. A 6-year-old Australian Shepherd developed bilateral stifle joint luxations and fibular fractures following 8 doses of Librela. The MAH filed an AER designating this reaction as not serious.
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ADR – Adverse drug reaction
AE – adverse event
AER – adverse event report
aNGFmAb – anti-NGF monoclonal antibody
CT – computed tomography
EVD – EudraVigilance database
EEBVS – European Board of Veterinary Specialisation
EMA – European Medicines Agency
FDA – Food and Drug Administration
HCF – humeral condylar fracture
HIF – humeral intracondylar fissure
MAH – marketing authorization holder
MRI – magnetic resonance imaging
MCP – medial coronoid process
MSAE – musculoskeletal adverse event
MSAER – musculoskeletal adverse event report
NGF – nerve growth factor
NSAIDs – non-steroidal anti-inflammatory drugs
OA – osteoarthritis
RPOA – rapidly progressive osteoarthritis
REMS – risk evaluation and mitigation strategy
TPLO – tibial plateau leveling osteotomy
VeDDRA – Veterinary Dictionary for Drug-Related Adverse Reactions
VMD – Veterinary Medicines Directorate
Keywords: bedinvetmab, Librela, NGF, rapidly progressive osteoarthritis, RPOA, accelerated joint destruction
Citation: Farrell M, Waibel FWA, Carrera I, Spattini G, Clark L, Adams RJ, Von Pfeil DJF, De Sousa RJR, Villagrà DB, Amengual-Vila M, Paviotti A, Quinn R, Harper J, Clarke SP, Jordan CJ, Hamilton M, Moores AP and Greene MI (2025) Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela). Front. Vet. Sci. 12:1581490. doi: 10.3389/fvets.2025.1581490
Received: 22 February 2025; Accepted: 04 April 2025;
Published: 09 May 2025.
Edited by:Ismael Hernández Avalos, National Autonomous University of Mexico, Mexico
Reviewed by:Tania Perez Jimenez, Washington State University, United States
Agatha Elisa Miranda Cortés, National Autonomous University of Mexico, Mexico
Copyright © 2025 Farrell, Waibel, Carrera, Spattini, Clark, Adams, Von Pfeil, De Sousa, Villagrà, Amengual-Vila, Paviotti, Quinn, Harper, Clarke, Jordan, Hamilton, Moores and Greene. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Mike Farrell, vetlessons@gmail.com; Ines Carrera, inescarrerayanez@gmail.com; Louise Clark, louise.clark@vetspecialists.co.uk
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Source: Frontiers in Veterinary Science
Librela, known as Beransa in New Zealand, came onto the market in 2023 in both the USA and New Zealand (it has been introduced earlier in the UK and Europe, in 2021). In late 2023, I shared this post from Dr Darryl Millis about things to consider before choosing to use it with your dog.
Librela/Beransa is an injectable treatment for canine osteoarthritis manufactured by Zoetis.
The drug works by targeting and blocking the action of nerve growth factor, NGF, with a monoclonal antibody called bedinvetmab. NGF is a protein that plays a role in the pain and inflammation associated with osteoarthritis. By binding to NGF, bedinvetmab prevents NGF from activating its receptors on nerve cells, thus blocking the pain signal.
In December 2024, the US Food and Drug Administration (FDA) issued an open letter to veterinarians with an update on its evaluation of adverse effects. That report concluded:
Based on the evaluation and analysis of the reports and signs seen for Librela, the
recommendation is to add a Post Approval Experience (PAE) section to the current label:
Post Approval Experience Section (2024)
The following adverse events are based on post-approval adverse drug experience reporting
for LIBRELA. Not all adverse events are reported to FDA/CVM. It is not always possible to
reliably estimate the adverse event frequency or establish a causal relationship to product
exposure using these data.
The following adverse events in dogs are categorized in order of decreasing reporting
frequency by body system and in decreasing order of reporting frequency within each body
system:
Neurologic: ataxia, seizures, paresis, proprioceptive deficits, paralysis
General: anorexia, lethargy, recumbency
Renal/Urinary: polydipsia, polyuria/pollakiuria, urinary incontinence
Gastrointestinal: vomiting, diarrhea
Musculoskeletal: muscle weakness, muscle tremors, lameness
In some cases, death (including euthanasia) has been reported as an outcome of the
adverse events listed above.
In addition, we suggest that owners be advised of the adverse reactions that may occur
following administration of Librela.
In the USA, a lawsuit has been filed alleging that Zoetis acted in a negligent manner in promoting its product.
In Australia, a class action lawsuit is being prepared by pet owners who state that their veterinarians described Beransa as a safe and effective drug without known side effects.
Why am I writing this post? To educate and to inform. I’m mindful that many of the commercials for human medications these days remind consumers “All medications have risks and benefits. Talk to your doctor to see if this product is right for you.”
There are veterinarians and dog owners who are reporting good results with this medication, particularly for those dogs who are elderly and for whom other arthritis medications have not worked. If your vet has recommended Beransa, be sure they have explained the possible risks to you and that you are happy to accept those risks on behalf of your dog.
Kathleen Crisley is Fear-Free certified dog massage therapist and canine fitness trainer. She has a particular passion for working with dogs and their families to ensure injury prevention and quality of life. She specialises in working with anxious and emotionally damaged dogs. Her mobile practice, The Balanced Dog, is based in Christchurch, New Zealand
Posted in Dogs
Tagged Dog, dogs, health, lawsuits, Librela, monoclonal antibody, osteoarthritis, pain medication, pets, wellness, Zoetis
The 4th rung of our ladder is about modifying exercise. This particular aspect is easy to explain, but many owners find it a challenge to put into practice because they build a routine of dog walking or perhaps ball chasing as their dog’s sole form of exercise.
And as I discussed in Part One of this series, our dog’s age often creeps up on us because they are aging faster than we are.
An older dog needs age-appropriate exercise based on their physical ability. A dog that walked for 10 kms when it was aged four may not be able to cope at aged eight, nine, ten, or more (every dog is different).
But, our dogs love us and so many will continue walking to the point of collapse which is what happened here in 2016 to a 12-year old Huntaway. In this case, the dog was taken on a steep hill track with, no doubt, the best of intentions. She walked until she could walk no farther, collapsing and spending the night in the freezing cold until she could be rescued.
The duration of a walk is just as important as its intensity. A walk in soft sand at the beach or hill walks are much more intense that an amble around your neighborhood on flat ground.
I often ask clients to monitor the amount of exercise their dog is getting by recording both the amount of time they spend out and also distance walked. (A Fitbit or other fitness tracking device can be used for this). Because I practice in-home, I usually get a good understanding of the local area where the dog is often taken for its walks.
Just because your dog wants to chase the ball, or run, or walk for hours, doesn’t mean he/she should. It’s our responsibility to moderate their exercise – even if that means that we can no longer run with the dog that has run with us for years.
Replacing high impact exercise with brain games – foraging for kibble in the yard, as an example – presents an aging dog with the chance to weight shift and walk at a pace that suits them and on familiar ground. If they get tired, they can rest easily.
Sometimes, it’s as easy as alternating a day with a longer walk, and then maybe only short toilet walks – or no walk – the following day.
In Izzy’s case, we are dealing primarily with corns in her right front paw that are aggravating arthritis in her carpus (wrist). There have been days when she tells me (by refusing to go out the front door), that she doesn’t want to walk. We often get in our morning walk with no issues. But her afternoon walk can be variable. There are days where we have no issues. On some days, though, she will start out with a happy gait and no lameness and then she’ll start to slow up, sometimes I’ll notice a small trip or scraping of the nails or she will be walking with her head held low – a sign she is tiring.
That’s when we use her pram so she can continue with sights and smells, but with no walking. The ultimate in modified exercise!
The biggest hurdle I often face is owners who just don’t seem willing or able to modify their daily routines to accommodate their dog’s changing needs. It’s part of our lifetime responsibility. Be flexible. Be resilient. Be kind.
If your feet were hurting, you’d want to slow down – wouldn’t you?
Got questions about this post? Please feel free to post a message or contact me through my practice, The Balanced Dog.
Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand
Tagged ageing, aging, arthritis, exercise, osteoarthritis, senior dog
The third rung of our ladder is Food & Supplements. As promised, this post is dedicated exclusively to supplements (I discussed Food in part 4). Brace yourself – this is another long post and I am not promising to cover the range of supplements available, either. These are some that I have personal experience with and I will explain my rationale for using them so you understand my principles for supplement use.
Supplements are a huge industry in both human and animal care and they earn a lot of money for the manufacturers that sell them. And for the most part, the industry is unregulated which means that, while we can buy them easily, there aren’t standards of manufacture and they can reach the shelves with little if any study as to their effectiveness.
That said, for many generations people had to rely on non-drug solutions to healthcare before there was such a thing as a pharmaceutical industry. And the structure of clinical trials is a modern medicine concept. I keep an open mind about natural remedies – and doing one’s homework is the best way to make good choices. (I have also found that the same people who claim that research paid for by manufacturers is dubious also endorse prescription dog foods that are also backed up by self-funded industry research – go figure!)
If you remember nothing else from this post, please remember these 4 key points:
| Let’s get the CBD thing out of the way first
CBD (cannabidiol) has only begun to be tested on animals. But it is in lots of products and supplements – at last year’s Global Pet Expo and other trade shows – it was CBD that was all the rage. A huge market with lots of money changing hands seemed to spring up overnight. In New Zealand, “tetrahydrocannabinols, the chemicals in hemp which include THC, cannabidiol (CBD), and related compounds, and any preparation or plant containing them, are classed by the Ministry of Health as controlled drugs under the Misuse of Drugs Act 1975. Under the ACVM Act, controlled drugs and anything containing them must only be given to or fed to animals after registration under the ACVM Act. When products are registered, MPI applies strict controls and conditions of sale and use.” (Source: Ministry of Primary Industries) My natural health colleagues in the USA have expressed concern about CBD products and how they may interact with other medications that pets may be taking (compounded by the fact that many pet parents are reluctant to disclose to their vet that they are using a CBD product). And others are concerned not so much by the CBD ingredient itself but because of the quality of the carriers and flavourings used in the CBD products. I know there are CBD products being given to dogs in NZ on the quiet – clients have asked me about products they’ve seen in local health shops and ‘green expos’ and a rumour that some pet parents are making it themselves. I’m taking a wait-and-see approach to CBD. And I’m following the research with interest! |
So earlier I said that we should supplement for a reason. I knew Izzy was an ex-racer who would have experienced a lot of stress on her joints during her professional career. So I started her almost immediately after adoption (around age 6) on glucosamine and chondroitin. These were to support her cartilage matrix and she continues on them to this day. My choice to start supplementation was based on her history and my assumption (rightly) that she would likely develop arthritis.
Glucosamine and chondroitin through studies have shown a chondroprotective effect. Chondroprotectives are “specific compounds or chemicals that delay progressive joint space narrowing characteristic of arthritis and improve the biomechanics of articular joints by protecting chondrocytes.”
I started Daisy on glucosamine and chondroitin at the magic age of 7 (that imaginary line that, when crossed, helps us generally to define dogs as being senior). She also remained on them until she passed 3 weeks after her 14th birthday.
When I said that supplements weren’t drugs, it also means that you need to maintain the dosage for them to remain effective. And if you stop or run out, then you can expect to have to re-start a program of loading to build them back up in the body again.
Another example of supplementing for a reason is when a dog has arthritis – and many dogs develop this condition (between 60% and 80% of dogs to be exact – according to different studies). Arthritis causes inflammation in the joints. Controlling the inflammation helps to control the pain.
Izzy also takes deer velvet and has done since she turned 7. (I started Daisy on deer velvet very late in her life, as the product was new to me then back in 2013/14). There’s a great literature review out of Australia that talks about the different properties of deer velvet, for example. In the words of Dr W Jean Dodds of Hemopet/Nutriscan, deer velvet “helps alleviate arthritic symptoms by rebuilding cartilage, improving joint fluid, increasing tissue and cellular healing times, and improving circulation.” So I started Izzy on this when she was that much older, it seemed a good adjunct to her glucosamine and chondroitin particularly for the circulation effects and the growth factors that would help with any micro-tears in soft tissues.
Green lipped mussel extract is somewhat unique to New Zealand and the omega-3 polyunsaturated fatty acids have been shown in studies to have an anti-inflammatory effect. When Daisy’s lumbosacral disease was first confirmed via x-ray in 2011, she started on a high quality green-lipped mussel concentrate. Izzy, with arthritis in her wrists and toes, has been taking green-lipped mussel since 2018, when she dislocated her toe. The NSAIDs disagreed with her and so I felt that with her advancing arthritis in the toes, she needed consistent anti-inflammatory support.
I also use turmeric in Izzy’s food – she’s 11 now and I’ve been consistently using turmeric for about three months because it’s got anti-inflammatory effects and she seems to tolerate it on her stomach whereas we know from the times she has needed NSAIDs after surgeries that her stomach doesn’t cope. I’m using a combination of dried turmeric powder and fresh turmeric when I cook for her and I have noticed an improvement in her mobility in conjunction with our regime for managing her corns. (Her hydrotherapist noticed her enhanced mobility, too.)
With each of the supplements I’ve mentioned above, they were instituted one at a time and for a reason. If I choose to stop a supplement to try something else, I will stop the first supplement for about 3 weeks before starting the new one. That’s because I want to make one change at a time.
You may have noticed that I haven’t mentioned supplement brands in this post. That’s because my local market in New Zealand has different products than those of my readers elsewhere. And while I have preferred products, I also aim to understand the client’s budget and recommend the highest quality product that they can afford.
And as you’ve reached the bottom of this post, you may also realize that I spend a significant portion of my household budget on Izzy’s care. Supplements are just one aspect of her care and for a 75 day supply of her green lipped mussel, for example, I spend close to NZ$100.
Got questions about this post? Please feel free to post a message or contact me through my practice, The Balanced Dog.
Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand
Posted in dog breeds, dog care, Dogs
Tagged ageing, aging, arthritis, osteoarthritis, senior dog, supplements
We’re going higher up the ladder this week to the third rung: Food & Supplements.
In many resources, food and supplements are talked about together because food is eaten and most supplements are, too. I’m going to write about Food now, however, and save Supplements for the next post to keep the length of the post manageable and easier to read. There’s still a lot I want to cover.
So in my last post about weight management, I mentioned that sometimes I ask my clients to simply reduce the food they are feeding by up to 1/3 per meal because a diet food is not always needed if the diet is balanced. That advice was specifically addressing the need to lose weight.
| In Part 3, I also included a diagram about body condition. Dogs of all ages should be fed to body condition; the labels on dog food are a guide and not the Bible. So, if a dog is gaining weight, then we may cut back on food a bit and help them reach an ideal weight again. Sometimes, we end up cutting back too much and then we have to feed a little more.
This is where the ladder analogy helps us. We can go up and down a ladder fairly easily. And when managing our dog’s health, we have to be prepared to re-visit issues and change approaches accordingly. Sometimes we go up the ladder and sometimes we go down. |
Older dogs generally have a slower metabolism and combined with less physical activity because they are slowing down (with or without arthritis) – they require less calories.
There are also other considerations for diets when your dog is older.
For example, if your dog has been diagnosed with kidney disease, then a diet lower in protein is recommended because the kidneys process extra protein for removal in the urine. If the kidneys aren’t working well, we need to lessen the pressure on them. If this is the case, your vet will probably recommend a commercial diet to meet those needs.
Protein is important for muscles – keeping them strong and helping them to repair themselves. Proteins are a source of energy; they help keep the immune system strong, and have a role in creating enzymes and hormones. They’re an essential part of the diet.
(When I started making my own dog treats for sale, I remember talking with a Board-certified veterinarian at the Angell Memorial Animal Hospital in Boston. She was of the view then that all older dogs should have reduced protein diets. But in the intervening years, more research has shown that this is not the case. A lesson for all of us. As we gather more information through study and research, professional advice may change.)
In TCM (Traditional Chinese Medicine), we understand that older animals don’t have the digestive energy that younger dogs do. Therefore, protein sources should be highly digestible when you are managing an older dog. This is a main reason why I like the homemade and topper approach to foods. I use a good quality dry dog food, but I enhance it with many fresh ingredients.
A few sources of good protein toppers are:
I also cook my own toppers.
Toppers add palatability (taste) and because the dog’s sense of smell is much better than our own, I think the toppers add appeal through smell, too.
If a dog has an arthritis diagnosis, then “Joint Diet” foods are readily available and companies like Hill’s have undertaken feeding trials to prove their diets are balanced. As part of the research into the product, the veterinary team observed a reduction in the clinical signs of arthritis with a subsequent reduction in the dosages of anti-inflammatory drugs that were required to manage the dog’s pain and arthritis symptoms.
That said, I have never fed a joint diet because I really dislike the ingredient panel in these highly processed foods. I’ve always felt that if we are told to keep fresh things in our diet, then the same should go for our dogs. I can still use supplements and other modalities to manage arthritis and inflammatory pain. I just don’t need to have a ‘complete solution in a bag.’ (This post is getting long – see why I chose to leave Supplements to their own post?)
Because digestion in an older dog is slower, if they have less physical activity such as recovery from a surgery or advancing arthritis, they can also become constipated from time to time. Drugs like Tramadol are also constipating. (This happens in rest homes with older people, too. An older person who lives their life in a wheelchair and unable to walk around much and on medication often finds that it is harder to get the bowels moving.)
More fibre combined with good hydration helps keep the bowels doing what they need to do (rid the body of wastes and toxins) and the best addition to food for fibre is steamed pumpkin. I know that tinned or canned pumpkin is also very popular in the USA as well.
Parents need to watch what they are giving as treats, too. Treats are food and add calories to the diet – but they also add variety and variety is the spice of life! If an older dog has lost some teeth over the years, for example, harder treats may need to be avoided in favor of softer ones. If we are focusing on hydration to help manage constipation, softer texture treats or those that can be soaked in water are a good idea.
Izzy the greyhound with a pigs ear. These help to clean her teeth to some extent (although we brush her teeth every night, too). Treats add variety to the diet and because I source my pigs ears locally, I am more confident in their quality.
Got questions about this post? Please feel free to post a message or contact me through my practice, The Balanced Dog.
Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand
Posted in dog breeds, dog care, Dogs
Tagged ageing, aging, arthritis, constipation, diets, dog food, kidney disease, osteoarthritis, senior dog, supplements, treats
In Part 2, I introduced a ladder concept to explain that there were steps in managing an older dog, and particularly one that is likely to have arthritis.
This is what our ladder looks like now, with two rungs, because today we are talking about managing weight.
Overweight pets are a first world problem. We love our dogs, we use treats for training, and we keep using treats to show our love. Many of us don’t measure (or ideally, weigh) our dog’s food at feeding time. Portion sizes start to creep up.
And then our dog starts to slow down, not playing or running around as much. They don’t need as many calories but we keep feeding them the same as we have always done. So with less calories burned, the dog’s body adds fat placing more stress on joints that are arthritic because they now have to move more weight than they used to (or should).
As with any change in lifestyle, a vet check is always recommended before starting a weight loss program. We don’t want to assume that weight is the only problem in an older dog. (Kidney and liver function, for example, should be checked).
I advise my clients to weigh their dog as a starting point and it’s also helpful to take measurements such as the waistline line (in line with the knees) and a measurement behind the elbows.
I often ask my clients to simply reduce the food they are feeding by up to 1/3 per meal (requiring them also to measure or weigh up what a ‘normal’ feed has been). A diet food is not always needed if they are already feeding a balanced diet.
Other tricks include scattering food around the garden or living room which requires the dog to forage for its food and, while doing that, they are getting some additional low impact exercise. Snuffle mats, which I sell in my practice, are another slow feeding option. Kongs are another.
Kobe the greyhound with a snuffle mat
Everyone in the household has to be on board with the weight loss program – sneaking treats just doesn’t help the dog reach its weight loss goal.
Regular weigh-ins and measurements will help you stay on track and be able to celebrate each weekly (or fortnightly) weight loss. And we celebrate with some play, a tummy rub, massage or a car ride – definitely not food!
I use massage and acupressure to help my clients through weight loss. Because if the dog is feeling less painful with endorphin release and muscles that are stretched and supple, they will move more. And with increased movement brings an increase in calories burned.
I also become the dog’s private weight loss coach, and a sounding board for the family so we can remain positive when we have setbacks.
It becomes a happy cycle of more weight loss, happier dog and happier family.
Many parents just don’t realise that their dog is overweight. Overweight dogs have become something of a normal occurrence in many communities. A good rule of thumb is to lay your hands on either side of your dog’s rib cage. Can you feel the ribs without pressing down? If not, your dog is probably carrying some extra weight.
Charts like this one are also useful. They are often on display in vet practices to help the veterinarian explain to clients about body scores and condition:
Got questions about this post? Please feel free to post a message or contact me through my practice, The Balanced Dog.
Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand
Posted in dog breeds, dog care, Dogs
Tagged ageing, aging, arthritis, osteoarthritis, overweight dogs, senior dog, weight gain
According to statistics, one in every five dogs is affected by arthritis, or more specifically osteoarthritis. It’s a disease that is progressive and is associated with a number of factors which result in degeneration of the joints.
In my opinion, the stats are probably a lot higher. More than one in five. And that’s because too many dog parents see the symptoms of arthritis but classify it as ‘normal slowing down with age’ and they don’t seek professional help until much later – if at all. Arthritis can develop in young dogs – I’ve seen it in dogs between the ages of 1 and 2 – but the odds certainly increase with age. If a dog reaches the age of 7, then they have a 65% chance of developing arthritis.
So in this post, I want to introduce you to the ladder concept for managing dogs with arthritis. There are various rungs to the ladder and we’re going to cover each one. Each rung is a step up in terms of effort (and potentially cost) and, just like in real life, you can go up and down the ladder based on circumstances which can include progression of the disease.
The first rung is about identifying pain and discomfort in your dog. Many owners expect their dog to whimper or cry out as the primary indicator that they are uncomfortable. But that just isn’t true. By the time a dog vocalises, chances are they have been experiencing discomfort for some time and have become very painful.
| There are degrees of difference between discomfort and pain
Discomfort is tolerable. People describing discomfort use words like lingering, annoying, or aching. Pain is much more than discomfort. Pain is intense. It changes the way you do things or enjoy your day. When people describe pain they choose words like burning, sharp, or shooting. |
Discomfort tells us something is wrong and often helps us manage before the situation becomes painful.
Our dogs are non-verbal communicators. We have to become experts at their non-verbal communication by being keen observers.
In late 2017, for example, I noticed a behavioural change in Izzy. Over the course of about 10 days, it seemed that almost every time I looked over at her, she was licking her left carpus (wrist). And so I took her to the vet and asked for x-rays. These confirmed ”very minor arthritic changes” – so minor that we agreed a regular rubdown with an animal liniment would likely be sufficient rather than requiring pain medication. Izzy was experiencing discomfort and not pain.
Changes can be subtle. My intake questionnaire for new clients is many pages long and I ask questions about mobility and behaviour as well as personally observing the dog’s gait. A reluctance to get out of bed in the morning may not be a sign of laziness, for example. It could be that the dog is stiff after resting all night.
Other signs can include:
The list goes on…
When we see someone every day (and this includes our pets), we often don’t pick up on small changes. This is a main reason why asking for a professional’s assessment is a good thing to do. They come into your situation with a fresh set of eyes.
Got questions about this post? Please feel free to post a message or contact me through my practice, The Balanced Dog.
Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand
Posted in dog breeds, dog care, Dogs
Tagged ageing, aging, arthritis, Greyhound, osteoarthritis, pain, senior dog
Arthritis is a common condition in older dogs. At first, though, owners may not always realise when their dog is suffering. That’s because dogs tend to hide discomfort and pain from their pack.
Signs that your dog may be suffering from arthritis include:
One day in 2011, Daisy let me know something was wrong. We were out walking and she slowed down and stopped and the look in her eyes was one of pain. She had finally let me know that she wasn’t feeling herself.
A series of x-rays confirmed arthritis in her lumbosacral spine and left hip.
Since then, she has responded to rest, conventional treatments, hydrotherapy, and other complementary therapies including my massage and laser treatments.
Quality of life for an arthritis sufferer can be attained – once the owner is aware of the problem!
Researchers at Kansas State University are devoting their time to the study of improvements in pain management and the treatment of osteoarthritis in dogs. (For more information on pain management, see my June 2012 blog)
The projects are led by James Roush, a professor of clinical sciences.
In one study, the research team determined that the maximum effective time for using hot and cold packs for pain management is 10 minutes. The researchers studied how packing affects tissue temperature in beagles and beagle-sized dogs after surgery because hot and cold packing is a common technique for reducing swelling. After 10 minutes, the maximum change in tissue temperature has been reached.
In another study, a special mat is being used to study lameness in dogs suffering from osteoarthritis. When dogs step on the mat, it measures the pressure in their step and the study team can determine in which leg the lameness is worse.
“We’ve designed the study to help improve osteoarthritis treatment,” Roush said. “We will also use it to measure clinical patients when they come in for regular checkups. We can measure their recovery and a variety of other aspects: how they respond to nonsteroidal anti-inflammatories, how they respond to narcotics or how they respond to a surgical procedure that is designed to take that pressure off the joint.”
And in a third study, Roush is collaborating with researchers to study the effectiveness of a painkiller used to treat dogs to identify potential alternatives.
“To achieve the drug’s effect, the dosage in dogs is much higher than in people,” Roush said. “It also may not be a very good analgesic in dogs. We want to see if there is an alternative that requires smaller doses and does not have not as much of a discrepancy for patients.”
DoggyMom.com 