Jim Kling ([info]jkling) wrote,
@ 2008-02-01 10:18:00
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for SCIENCE!
Yesterday, [info]mareklamo and I brought [info]lilaboux and [info]ahltis to the vet for a checkup. The vet commented on how healthy lilaboux is for an 18-year old cat, and then asked if we would be willing to enroll her in a clinical trial for a nonsteroidal anti-inflammatory drug (Robenacoxib), sponsored by Novartis Animal Health. They took some blood samples and X-rays to determine if she has physical signs of osteoarthritis, which the drug is designed to treat, and to be sure that she is sufficiently healthy to participate. If she meets the criteria, we'll be given either the drug or placebo to administer once a day for 30 days. mareklamo will keep a journal recording any changes in her gait or other signs of improvement. mareklamo and I initially marveled at the idea of including a placebo for a study on cats, but then we realized it's for us -- since we'll be the ones monitoring her and recording changes. If we expect the drug to cause improvements, then we might exaggerate improvements or see improvements that aren't really there.

Unsurprisingly, lilaboux disapproves.

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[info]ellameena
2008-02-01 09:57 pm UTC (link)
I'm not sure if you've heard this story, but our dog was killed in December 2006 by metacam, an NSAID for pets. NSAIDs in pets have had a very troubled history, and so far each one has been associated with toxicity. Metacam was supposed to be the new, "safe" drug, but, as I said, it killed my dog. The company even sent us a check to pay for some of the diagnostics that we went through. One problem with them is that the complications they cause are difficult to perceive from the outside. Our dog began acting painful. We assumed it was her arthritis, and continued medicating. It was actually her STOMACH, which resulted in a huge ulcer and sudden loss of half of her blood volume. There were other symptoms that could have warned us a bit earlier, and I kick myself over it all the time. Another thing I worry about, and this is more speculative, is that the molecular mechanism of NSAIDs may be inherently more toxic to dogs and cats. We know that inhibiting COX1 causes problems in humans, and we've also seen major problems with COX2 inhibitors such that a couple of them have been pulled from the market. We don't have good data on animals, though, because when a pet dies suddenly after being on a drug, most people bury them in their back yard, instead of paying for a post mortem exam. But we do know that dogs and cats are metabolically very different from humans, and that some things that are not toxic to us are toxic to them. A significant finding if you read the fine print on metacam is that stomach irritation is universal, and in fact it's recommended to start medication to protect the stomach at the same time the metacam is started. This is a different toxicity profile from human NSAIDs. I've wanted to write an article based on this experience, but haven't found the time or the right venue. I will never give a pet of mine an NSAID again. In fact, I was offered metacam for my cat recently and turned it down flat.

Anyway, all of this is to say that if your kitty is really suffering from arthritis and you feel it's worth the risk--good luck! But if she is in very good health, she will probably be with you a couple more years, and animals relate to pain differently than people. To her a daily reality that includes arthritis pain probably does not entail the level of "suffering" that we humans would experience due to our overdeveloped neocortex (or whatever). Nala's health was excellent in Oct. 2006, at the time she was put on metacam. Her liver panel was excellent, and the vet even commented that usually at 10 years, a dog would have some values that were slightly off. In retrospect, I would have rather accommodated her decreasing mobility for another year or two than her sudden, traumatic death. :-(

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[info]jkling
2008-02-01 11:38 pm UTC (link)
Thank you for telling me about this. I'm really sorry to hear about your dog. If it makes you feel any better, I think it's very common to miss symptoms in an ailing pet since they can't tell us what's wrong.

I'll look into this more before agreeing to the trial. The vet said it was a phase III trial, which implies that safety trials have been done -- I'm going to call the vet and confirm that, as well as request the incidence of side effects in the earlier studies.

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