In my last column, I shared
with you the events of the last two months of my dog’s
life. How he went from an apparently healthy senior dog to
one so weak and ill that my husband and I made the heartbreaking
decision to let him go. The span of time between health and
illness was so short that I began to wonder if the arthritis
medication I had given him was the trigger.
I remembered an article on arthritis medications
I had read some months back in “The Whole Dog Journal”.
I was determined to find it and when I did, I read it over
twice. It made me wonder even more.
This article, written by Lexiann Grant, titled
“Administer With Care,” was from the June 2003
edition of The Whole Dog Journal. It was rather lengthy but
I decided then that even though I couldn’t cover all
of the good points, I had to share some with you.
Grant’s article concerns itself with
non-steroidal anti-inflammatory drugs (NSAIDs) in general
and Rimadyl, EtoGesic, and Deramaxx in particular. These drugs
are similar but made by different drug companies and are widely
prescribed for pain and to reduce the inflammation caused
by arthritis. All of these drugs were approved by the Food
and Drug Administration’s Center for Veterinary Medicine
(FDA CVM) after reviewing “premarket approval studies”
supplied by the drug companies.
Rimadyl (carprofen) was originally intended
for human use but was changed to veterinary use and came on
the market in 1997. It appeared to be a godsend. Owners who
gave it to their arthritic dogs saw their dogs romping and
running and playing again. But with the apparent success of
the drug came increased usage and with increased usage came
increasing reports of dogs who had become ill after taking
Rimadyl.
The Center for Veterinary Medicine of the
FDA keeps track of what they call Adverse Drug Experiences
(ADE) reported by veterinarians and people like you and me.
At first, the side effects reported to the CVM were in line
with the premarket studies: vomiting, loss of appetite, lethargy,
changes in kidney and liver enzymes, increased urination,
diarrhea (sometimes bloody), weakness, confusion, and even
convulsions. Since these side effects were common to NSAIDs,
no alarm bells went off. But then reports of dogs dying began
to come in.
Though deaths seemed rare at first, over the next few years,
with over 2 million arthritic dogs on Rimadyl, Grant writes,
“a full 39 percent of the ADE reports in 1998 involved
Rimadyl. Of these, 13 percent (about 471 cases) resulted in
the death or euthanasia of the dogs.”
Page 2.
With these numbers in mind, the CVM met with Pfizer (the maker
of Rimadyl) and, based on the CVM’s suggestions, Pfizer
issued numerous informational printouts for veterinarians
and for patient handouts detailing clinical experiences with
the drug. They also put new information under the “’Adverse
Reactions’” section of the product label.
Two other NSAIDs were subsequently approved
for veterinary use: EtoGesic (etodolac) in 1998 by Fort Dodge
Animal Health, a division of Wyeth; and Deramaxx (deracoxib)
in 2002 by Novartis. Deracoxib is almost identical to the
human drug Celebrex and though originally approved for surgical
pain, it is expected to be approved for osteoarthritis.
EtoGesic, though not as widely used as Rimadyl,
is following in its footsteps. The more widely used it becomes,
the more ADE’s are reported. Fort Dodge was also advised
to increase its informational printouts to veterinarians and
consumers. The jury is still out on Deramaxx, but there have
already been 100 ADE reports on it as of February 2003.
If NSAIDs are advised for your dog and you
think it is the right thing to do, here are some recommendations
from Grant’s article: Schedule a full exam to determine
if in fact your dog has arthritis and not some other disease.
Insist on full lab tests (blood and urine) prior to using
NSAIDs. Do not change NSAIDs without at least a two-week,
drug-free window between medications. Insist on periodic blood
tests while your dog is on the medication to alert you to
any potential problems. Give NSAIDs with food. Be aware of
NSAID interaction with other drugs. Ask your veterinarian
for and read the information provided by the drug companies
about possible side effects. Be aware of side affects and
what they look like and discontinue use immediately if you
suspect a problem. Consult your veterinarian.
If you suspect a drug interaction, you may
want to call the Center for Veterinary Medicine at the FDA
at (888) 332-8387 to report it.
If you have access to the Internet, you
can search for background information on these drugs. The
following two sites were suggested to me: www.askjeeves.com
and www.Google.com. Type in the medication you’re interested
in and go from there. If you have your dog on Rimadyl, you
will definitely want to go to www.srdogs.com, click on Rimadyl
news site and then click on Wall Street Journal 3/13/00 article
listed on the left.
I will never know if the medication I gave
my dog caused or triggered his ill health, but I am determined
to be better informed next time. In answer to a number of
inquiries, my dog was not on Rimadyl. He was on Zubrin, a
much newer medication about which I have found very little
on the Internet.
For a back copy of the June 2003 issue of
The Whole Dog Journal, go to www.whole-dog-journal.com. Or
call (800) 424-7887.
Page 3
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