Big in Europe and Coming Your Way: New Osteoarthritis Pain Med for Dogs

A new pain med for canine osteoarthritis has had promising results in Europe. photo: AdobeStock

Canine osteoarthritis (OA) is no fun. It’s a degenerative joint disease that ultimately leads to functional decline of the joint, resulting in lameness and chronic pain for the dog.  

What Causes OA?

OA occurs when bones of a joint don’t fit together perfectly (as in the case of hip or elbow dysplasia) or if there is a ligament sprain or rupture (as in the case of cranial cruciate ligament disease). The joint becomes unstable, leading to the breaking down of the normal cartilage cushion in the joint. Eventually, the bones in the joint rub against each other, causing pain, decreased joint movement, and sometimes the formation of bone spurs or other changes in and around the joint. 

How Common Is It?

OA typically continues to worsen over the life of a dog. But while the prevalence of OA is higher in aging dogs, younger dogs can have it, too. It’s been reported that about 20% of dogs over one year of age have OA and that as many as 40% of all dogs show signs of the disease. 

Canine osteoarthritis is an undeniably common problem, yet it’s not always diagnosed or treated correctly. In fact,  it’s estimated that only a third of the dogs experiencing OA receive treatment for it. 

In part, that’s because it’s easy to misunderstand the early signs of OA pain, such as lagging on walks, reduced enthusiasm for playing, and reluctance to jump into the car or climb stairs. Recognizing and reporting to your veterinarian any subtle early changes in your dog's discomfort - including changes in gait, energy, and behavior - is key to early OA detection. That’s important because getting ahead of chronic pain will help preserve your dog’s quality of life and reduce pain over time.

In fact, OA can affect dogs as early as their first birthday if they are born with hip or elbow dysplasia or have an injury leading to an unstable joint. But because it’s long been thought of as a ‘senior dog disease’ it’s not always considered a possibility for young dogs and is frequently overlooked.  Sadly, OA is often missed until the dog starts refusing to participate in activities like playing catch or going for a walk or begins to hide or show aggressive behavior due to their pain. By that time the joint damage is already quite severe and the dog is in chronic pain.

That’s a huge problem because, not only does a missed diagnosis and lack of early interventional treatment impact the dog’s comfort and well-being, but it also can shorten life expectancy by as much as two years. 

What’s This New OA Pain Treatment?

The good news is that in addition to traditional pain management treatments for canine OA, the U.S. Food and Drug Administration (FDA) recently approved a new pain management treatment specific to dogs called Librela. 

The active substance in Librela is Bedinvetmab, a monoclonal antibody (a type of protein) designed to recognize and attach to a protein called nerve growth factor (NGF). Once attached, it prevents NGF from attaching to its receptors (targets) on nerve cells and interrupts the transmission of pain signals.  

Librela works by binding to and inhibiting the biological activity of a protein called ‘canine nerve growth factor’ (cNGF), which has been found to be elevated in dogs with OA and is involved in the regulation of pain. When Bedinvetmab binds to NGF, it prevents the pain signal from reaching the brain. Over time, the transmission of chronic pain is lessened to the point where the dog can return to more active use of an arthritic joint and feel less pain afterward. 

How Was Librela Tested?

Two field studies were conducted to evaluate the effectiveness of Librela, one in the United States and one in the European Union. Both studies enrolled client-owned dogs diagnosed with OA. Half the dogs received Librela and half the dogs received a sterile saline injection every 28 days for a total of three doses. 

Before treatment and on various days throughout the study, owners used the Canine Brief Pain Inventory (CBPI) assessment tool to measure the severity of the dog’s pain and the degree to which the pain interfered with the dog’s daily activities. The weight of evidence from the two field studies demonstrated that Librela is effective at controlling pain associated with OA in dogs when at least two doses are given 28 days apart.

Librela is currently approved as a monthly injection under the skin, initially tried for 3-4 treatments and then for use ongoing as needed based on the dog’s response to treatment.  It may provide a safer long-term alternative to other traditional canine OA pain medications called ‘non-steroidal anti-inflammatory drugs’ (NSAIDs) such as Rimadyl, Metacam, Deramaxx, Previcox, or Galliprant.  

When Will It Be Available and Who Can Take It?

Expected to be available to U.S. veterinarians by late October, Librela has been used by veterinarians in Europe for more than two years and the results have been largely positive, with European vets giving the treatment an overall thumbs up for reducing pain. Librela may be administered to dogs in any stage of OA, which means dogs can begin to receive treatment at the very first signs of OA pain. Additionally, there are no weight restrictions, so even the smallest patients may potentially benefit, as long as they’re at least a year old. Librela has not been evaluated in dogs younger than one year.

This does not mean that all dogs will respond to this medication right away. Response to treatment will vary for individual patients, but in EU clinical studies, dogs were treated for as long as nine months and maintained a response to therapy during that time.  Dogs with OA should also continue with other joint support medications and supplements such as Omega 3 Fatty Acids and Adequan, an injectable medication form of liquid cartilage that is very effective at modifying OA and preserving cartilage.

Any Side Effects?

While side effects are not common, some side effects reported in dogs treated with Librela in Europe and Canada included increased blood urea nitrogen (an indicator of kidney function), urinary tract infection, bacterial skin infection, skin irritation (dermatitis), rash (erythema) or pain at the injection site, vomiting (emesis), and weight loss (anorexia). This means monitoring will be important for any dog treated with this novel medication.

No medication is perfect for every dog. But the availability of this new non-NSAID monthly treatment for canine OA pain is an exciting advance for everyone who cares about improving the quality of life for their dogs. To learn more about Librela, please visit the FDA website here.