Librela, a medication given to dogs by monthly injection to treat arthritis that has been available in the US for a little over a year (longer in the UK, Canada, the EU, and Australia), is raising alarm as more dog owners report serious side effects.

The concern is enough that the FDA issued a warning letter to veterinarians and the New York Times published a warning.

About Librela

Librela is what is called a monoclonal antibody drug. It blocks activity by specific proteins that transmit pain signals, thereby relieving pain. At least, that’s the idea.

Reports of serious reactions include neurological signs, such as ataxia or seizures; muscle weakness, and inability to stand or move around. Some dogs have died.

According to the AVMA (American Veterinary Medicine Association, more than 3,600 adverse reaction reports had been filed as of April 2024 (at this time, Librela had been available for less than a year). Of these, 70% occurred after a single injection; many within a day. The packaging does not list these side effects (though what it does list seems pretty unpleasant). So, Dogs Naturally shared the side effects listed on US and Canadian packaging:

“The listed side effects on the Canadian insert for this medicine (much more comprehensive than in other countries!) include:

• Swelling at the injection site
• Systemic disorders: lack of efficacy, polydipsia, death, lethargy, anorexia
• Renal and urinary tract disorders: poluria, urinary incontinence
• Digestive tract disorders: diarrhea, vomiting
• Neurological disorders: ataxia, seizure

The US prescribing information lists the most common adverse reactions as …

• Urinary tract infection
• Bacterial skin infection
• Dermatitis
• Dermal mass
• Erythema
• Dermal cyst(s)
• Pain on injection
• Inappropriate urination
• Histiocytoma

These are ugly lists. Not to mention that many elderly animals already have compromise or disease in multiple organ systems. So this medicine may be the straw that breaks a whole lot of camel’s back in your dog’s system.”

These may well be the most common adverse reactions, and the number of dogs experiencing severe reactions may be relatively small. Which matters not at all when your dog is among them.

While many dogs do experience reduced pain and increased mobility, other dogs are reported to show:

• Lethargy
• Drooling, shaking
• Change in behavior, acting scared, hiding
• Urinary incontinence
• Refusing food or water
• Diarrhea, vomiting
• Ataxia, staggering, falling over
• Hind end weakness, unable to get up
• Kidney or liver damage
• Seizures (new or increased)

Your vet may — or may not — describe all of the potential side effects of Librela, so think carefully and consider other pain management options before choosing.

Arthritis pain management

The original Thinking Dog, Jana, had severe osteoarthritis from a relatively young age. By age 3 or 4, she was balking at going down stairs, and I knew something was wrong. We tried, with various success:

• Chiropractic adjustments
• Acupuncture
• Laser therapy
• Supplemements — green lipped mussel, glucosamine, turmeric
• CBD “treats”
• Herbal medicine
• Rimadyl and similar anti-inflamatory drugs

These helped Jana to feel better and remain active until she passed away several years ago at age 13 1/2. Cali also tried several of these approaches to pain management. Orly is a healthy, fit, and active 3-year-old who takes no medications (ah, youth!).

If I have another dog with arthritis, I will start with these options. I encourage you to do your own research! Each individual dog will respond differently to each treatment or combination of approaches.