Special Report (June
9, 2006)
Opinion
NSAIDs
Pain killers can be dangerous, too
By Kelly J. Kaczala
Press News Editor
In December, 2004,
Sue Draeger, of Curtice, noticed her black Labrador retriever,
Murphy, was sore from arthritis. Eager to alleviate its pain,
she took the dog, who was in otherwise good health, to her veterinarian,
who prescribed a common pain killer, Rimadyl (Carprofen). In the
next three weeks, Murphy's health declined so rapidly that Draeger
had the dog put to sleep.
"After three or
four doses of Rimadyl over six days, all of a sudden, she started
going downhill, fast," Draeger said of Murphy. "She
was just not herself. She was laying down a lot. On Christmas
Eve, she had a seizure. Before I gave her Rimadyl, she used to
swim in my pond. She was a great dog.”
Draeger, a registered
nurse, suspects Murphy may have had an adverse reaction to Rimadyl
after she learned of the drug’s potentially dangerous side
effects on the Internet.
Rimadyl, made by Pfizer
Animal Health, belongs to a class of Non-Steroidal Anti-Inflammatory
Drugs (NSAIDs) prescribed to control osteoarthritis and post-surgical
pain in dogs. While they are proven to be effective, some dogs
have suffered internal bleeding, liver and kidney failure, and
seizures from the drugs. Many have died.
Draeger, and others
whose pets have had adverse reactions to NSAIDs, share gut-wrenching
guilt for unwittingly contributing to the injury or death of their
dogs, unaware of the drugs’ possible side effects.
Sadly, Draeger's story
is a familiar one.
Changed forever
Jean Townsend, of Johns
Island, South Carolina, still feels guilty, she said, for giving
Rimadyl to her chocolate Labrador retriever, George, for arthritis.
The dog died of massive
internal bleeding and liver failure soon after being prescribed
the drug in 1997. Townsend joined a class action lawsuit against
Pfizer in 1999 for failing to warn pet owners about the drug’s
risks. Pfizer eventually settled out of court, without admitting
wrongdoing.
“George was never
tested to see if he were even a candidate for the drug,”
said Townsend, who later established a message board for dog owners,
DogHealth2. “George didn’t have a chance. When I lost
him, I lost a part of myself. His death has changed my life forever.
I had a hand in killing my beloved companion – and that
hurts.”
A veterinarian who
looked at George’s necropsy (autopsy) report said the drug
“literally blew him apart inside,” Townsend told The
Press. “I cringe every time I think about what my George
went through – and the fact that it was my doing –
makes it even worse.”
Lola Quinlan, of Jupiter,
Florida, took her 10-year-old German shepherd, Sam, to the veterinarian’s
to treat a sore leg. After being prescribed Rimadyl, the dog became
ill, dazed, and lethargic, lost its appetite, had excessive thirst,
and loose stools. Tests showed he had developed kidney problems,
said Quinlan. When his health deteriorated further, Sam was euthanized,
just days after getting the drug.
She is convinced it
was the Rimadyl.
“I am certain
the drugs were the leading cause of his premature demise. This
dog was extremely healthy. Never had a sick day in his life. Yes,
he had arthritis in his right hip, but not serious enough to die
from it,” she said.
The Food and Drug Administration’s
Center for Veterinary Medicine (CVM) urges veterinarians to distribute
Client Information Sheets (CIS) to pet owners that describe the
risks of NSAIDs. CIS are similar to package inserts pharmacies
include when filling prescriptions for humans that include a drug’s
risks.
“The Food and
Drug Administration works with the drug sponsors to develop Client
Information Sheets and other information that can help ensure
that approved veterinary medicines are used properly,” said
Linda Grassie, communications director at the FDA. “FDA
believes that these CIS can be helpful for pet owners and encourages
veterinarians to provide available CIS to their clients.”
Yet few pet owners
get that information.
"I never got a
Client Information Sheet," said Draeger. "I blindly
trusted my vet. I shouldn't have."
“Once a person
knows what a CIS is, they have the capability to make an informed
decision on whether they want to use that drug,” said Laurryn
Simpson, whose website www.DogsAdverseReactions.com provides the
latest information on NSAIDs and other medical news, as well as
CanineDrugDangers. “If they do, they know what to watch
for in case of an adverse reaction.”
Besides Rimadyl, other
commonly prescribed NSAIDs include Deramaxx (Deracoxib), Etogesic
(Etodolac), Zubrin (Tepoxalin), Previcox (Firocoxib), and Metacam
(Meloxicam).
The FDA was flooded
with reports of canine injury and death from Rimadyl soon after
it was approved in 1996. Of all the Adverse Drug Event (ADE) reports
received by the CVM in 1998, 39 percent, or 3,626, involved Rimadyl,
according to the FDA in December, 1999.
“The number of
ADE reports received by CVM for Rimadyl is considerably more than
that received for other animal drugs,” said the report.
Approximately 13 percent
of the 1998 Rimadyl ADE reports for dogs involved death, either
on their own or by means of euthanasia, according to the CVM.
Pfizer and other NSAID
manufacturers have issued “Dear Doctor” letters to
vets to inform them of the drugs’ risks and asking that
the information be passed along to pet owners. Still, most do
not inform pet owners of the drugs’ potentially lethal side
effects.
Legislation
Demitry Herman, an
animal welfare advocate in Pennsylvania, wants a law passed that
would change all that.
While acknowledging
NSAIDs have saved lives of dogs that might otherwise have had
to be euthanized from crippling arthritis, Herman nontheless has
been working tirelessly to get the legislature to support a bill
that requires vets to conduct pre-screened blood tests before
prescribing the drugs, and to hand out CIS to pet owners.
Herman's 11-year-old
schnauzer, Jetta, a licensed therapy dog, died after getting an
NSAID, Deramaxx, for a sore leg. Jetta died shortly after getting
the drug.
"My goal is to
get the word out to people that these NSAIDs work, but they're
not for every dog," Herman told The Press. "These vets
aren't doing the proper testing as the manufacturers suggest.
The FDA should require it. The vets are not telling us about side
effects, and death rates. These dogs are our kids."
Had he known about
the drug's risks, he would have recognized Jetta's symptoms, and
the dog might have been saved, he said.
"That pill hit
our dog right away. Jetta wasn't eating, had glassy eyes, staring
at the wall. I would have stopped the drug right away and got
her to the vet because the drug started eating through her stomach,"
said Herman. He rushed the dog to the vet, where it had a heart
attack, dying 48 hours after getting the drug.
"She was a strong
dog," he said. "This shouldn't have happened."
Herman wants the Pennsylvania
State Examining Board to require vets to give informed consent
to pet owners on the drugs’ risks, and to offer pre-screened
blood tests to determine if NSAIDs would be suitable for their
pets.
Herman is also seeking
appointment to one of two public seats on the board, which oversees
the veterinary profession.
"If the board
is not going to pass a regulation that says vets need to explain
the drug and give CIS to clients when they hand out the drug,
and do blood testing, then I'm going to have a law passed,"
said Herman.
"It costs just
$16 to test the liver and kidneys for suitability," he said
of the blood tests. "It's estimated that 35 to 50 percent
of dogs, if they were tested, would not be suitable for these
drugs."
The Ohio Veterinary
Medical Association (OVMA), which represents veterinarian interests
in Ohio, would oppose a similar bill if it were introduced in
Ohio.
“Veterinarians
should assist their clients in understanding the medications prescribed
for their animals, which may or may not include extensive written
materials,” Jack Advent, executive director of the OVMA,
told The Press. “Mandatory forms and the dispensing of large
amounts of information can at times desensitize clients to the
key facts they should be aware of. The information provided should
preferably be a matter of a variety of factors, including safety,
good customer communication, and prior client/patient experience
with the medication, among others. The administering of all tests,
including pre-anesthetic blood tests, should be left to the discretion
of the veterinarian based upon medical factors and professional
judgment; and the client, after those factors have been explained
to them.”
"If that's the
case,” said Herman, “then the vet should be responsible
if something happens.”
"If people know
ahead of time, then they can't go back to the vet and say that
they screwed up."
Features Editor Tammy
Walro contributed to this report
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