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Rimadyl – Reproduced with permission of Canine Health Concern© Rimadyl (Carprofen) was introduced by Pfizer Pharmaceuticals in 1997, has proven to be a successful means of relieving arthritis symptoms in dogs. Many users feel it has vastly improved the quality of their dogs’ lives and, in some cases, even extended their lives. However, there is a growing body of evidence showing that the drug has serious side effects. Some dogs have died due to the unexpected rapid onset of side effects, and/or because the drugs side effects were not recognised by the attending veterinarian who did not take the appropriate action. It was not at first clear that Labradors were particularly susceptible to Rimadyl Toxicity, since Labradors, more than other breeds, have joint problems and are given Rimadyl for relief. However, Pfizer’s report on side effects that occurred during the drugs initial postapproval phase states, “.... approximately one fourth of all hepatic reports were in Labrador retrievers.” This appears to be an alarmingly high incidence and should guide your choice of using Rimadyl if your dog is a Lab. Many breeds, including Labradors, are represented in the population that has experienced side effects or fatal outcome from Rimadyl. Although the deaths and side effects reported on their site are only a representative sample, you will find many different breeds named in the reports. Cautions about Administering Rimadyl In the data sheet, Veterinarians are advised to pre-screen a dog before prescribing Rimadyl and then to retest and closely monitor the dog for possible toxic reactions at periodic intervals. The Senior Dogs Project has had repeated reports from people who have discussed Rimadyl with their vets and found that their vets were not aware that pre screening and regular monitoring were suggested (but not required) by Pfizer. In many cases, the vets were not aware of the side effects of the drug, or the period during which side effects might occur. (Not: although originally this period was thought to be two to six weeks, adverse reactions have been reported after a matter of hours). Carprofen is not recommended for animals with known bleeding disorders and should not be used if a dog has pre-existing liver disease, inflammatory bowel disease, or a known tendency towards gastrointestinal ulceration. Rimadyl should never be given alongside any other non-steroidal anti-inflammatory drug (NSAID) such as aspirin, or along with any corticosteroids such as prednisone, prednisolone or dexamethasone. The University at Davis California recommends a two week “rest” period when changing from any NSAID to Carprofen or from Carprofen to another NSAID. If Carprofen is used concurrently with Phenobarbital, it is especially important that the appropriate liver monitoring be performed. (Mar Vista Animal Hospital recommends bile acid testing every six months for dogs on Phenobarbital). ACE inhibitors such as enalapril or captopril may not be as effective in the presence of Carprofen. (ACE inhibitors are used in the treatment of hypertension or heart failure). It is also advised not to give to pregnant or nursing females because it has not been tested on them. In cases where dogs have a toxic reaction and recovered, continued monitoring over an extended period, perhaps as long as a year may be advisable because the long term effects of liver or other organ damage are not yet known. A Review of the Controversy about Rimadyl Is Rimadyl a “miracle drug” that can help your dog? Or are the potential side effects too dangerous? There is a line-up on both sides of the issue. This website (http://www.srdogs.com/Pages/rimadylfr.html) has undertaken the task of posting reports of both negative and positive experiences with Rimadyl. The negative reports far outweigh the positive: However, that is not unexpected since people tend more often to report problems than satisfaction. Quite unexpected, however, and most disturbing are these factors that are emerging: (1) the lack of adequate warning about the potential side effects of the drug: (2) the number of veterinarians who seem unaware that Rimadyl has any side effects at all: (3) the severity and at times sudden onset of the side effects, which include death. The bottom line: many dogs seem to benefit from taking Rimadyl. Some who might have been euthanized due to mobility problems have been returned to excellent function and quality of life. On the other hand, an number of dogs have died – in many instances due to lack of knowledge about the drugs side effects. Some of those dogs could have been saved, had kidney and liver functions been monitored, the symptoms recognised, the withdrawn in time, and supportive therapy instituted. In other cases, the onset of liver, kidney or other problems was sudden and severe; there was no possibility of reversing the effects. The Pfizer literature states that Rimadyl sometimes “uncovers” an existing condition. It is not always possible to prove that the drug was responsible for causing the condition. Recommendations: be fully informed about Rimadyl’s potential side effects. Be sure your veterinarian is fully informed as well. The Senior Dogs Project website provides or has links to all the currently available information about drug administration, side effects and symptoms. Read the material carefully and thoroughly. Share it with your vet. With this information and in consultation with you vet, decide whether the risks are worth the potential benefits of the drug for your dog. Should you decide to use Rimadyl, observe your dog closely for signs of side effects, and have your vet do baseline screening and regular monitoring as suggested by Pfizer? Some Important Issues that have arisen from information received by the Senior Dogs Project 1. Is Pfizer doing enough to inform and educate veterinarians and the public about the administration and possible side effects of Rimadyl? 2. Should Rimadyl be recommended as a general pain reliever/anti-inflammatory, or are the potential side effects too serious for any situations but those in which there seems to be no safer alternative? 3. A new drug often produces side effects that were not evident in the clinical trials that led to FDA approval. However, is the incidence of deaths and other severe debilitation seemingly attributable to Rimadyl within acceptable FDA limits? 4. Is Pfizer consistent in recognising when Rimadyl is implicated and in reimbursing for related medical expenses? 5. Is it appropriate for Pfizer to require “gag” orders (confidentiality Agreements) be signed in exchange for payments of medical expenses to people whose dogs have taken Rimadyl and had adverse drug experiences?