http://www.i-dog.com/board/messages/46/46410.html?1071704230

Posted on Monday, December 08, 2003 - 4:26 am:
Hi -
I am a veterinarian that has stumbled across this thread after finding a link on the srdogs.com website. I think I am the only one that has dared pipe up (although I think a few techs did a long time ago). I've read this entire thread - 4 hours and I stayed up 'til 3am last night. I'll tell you my point of view. I know vets generally inhabit the other side of the exam table from your perspective, but these types of things can be tough on us too. (Although nothing can compare to the loss/injury of a beloved one!)

I found my way here while Google-researching adverse reactions to a new anti-inflammatory med called Deramaxx, which some people claim is leading to side effects in a large number of dogs (much like PH6). My psyche got a big bruising in the last few days because I may have contributed to the death of a client's beloved pet. This is a veterinarian's worse nightmare, believe me. You may distrust some vets because of you horrible personal experiences, but 90% of the vets I know lose sleep over the thought of harming a patient. (You can find 10% bad apples in any group).

I prescribed Deramaxx to a limping dog and 5 days later that pet developed severe hemorrhagic diarrhea with sloughing of the intestinal lining and shock. I cannot prove the Deramaxx was the culprit, because the documented Deramaxx reaction on the GI tract is ulceration, not sloughing (a subtle but important distinction), however I do think it’s highly likely the Deramaxx was to blame.

Now, my clinic started carrying this new medication about 3 months ago because we believed it would be safer than EtoGesic and Rimadyl. The manufacturer, Novartis, held a dinner lecture for the vets in our area and presented their research information at length showing that the GI side-effects were much reduced with Deramaxx. This sounded believable, since Deramaxx is almost identical to Celebrex and Vioxx, which are the “new and improved” prescription drugs for human arthritis. The FDA, which is notoriously hard to please (how many times do you hear people clamoring for the FDA to hurry up and approve some new wonder drug being used in Europe?) had signed off on it. And the research all sounded plausible and encouraging. We were excited to have a safer drug in our arsenal against canine pain.

I only prescribed the medication about 10 times over the last month, but in that short time I seriously injured a patient I was trying to help. Another vet where I work had 2 other patients die suspiciously after being prescribed Deramaxx, although these cases cannot be proved as adverse reactions either. We have, however, reported all three cases to the FDA and Novartis, and we have taken the Deramaxx off our shelves.

What does this have to do with ProHeart6? Our clinic has never used PH6; we prescribe Interceptor. But after my Deramaxx debacle, I have learned a painful lesson:

I will not prescribe any new medication before it has been on the market for a few years, and I will sniff around on the Internet as well before making a final decision on safety.

I am a scientist, and I believe that well-designed statistical research is vastly superior to anecdotal evidence found on the Web. But: ProHeart6 is still fairly new and there is not enough good research at this time. Because it may have a higher, potentially devastating complication rate, I will not use it. If we did not have perfectly good, tried and true heartworm prevention out there, then yes, I would advocate use of PH6 because heartworm is a serious risk in many areas of the country. But we do have Heartgard and Interceptor, so there is no good reason to incur extra risk on my patients. Because I love them. And I never want to have to face another grieving client and tell them that I was instrumental in the death of their dear dog.

VetMama (unregistered guest)