Misty, the 10-year-old Golden Retriever who inspired the Senior Dogs Project

The Senior Dogs Project
..........."Looking Out for Older Dogs" ...........

"Blessed is the person who has earned the love of an old dog."
Sydney Jeanne Seward


Rimadyl: Comments from Veterinarians and Vet Tech

Bloodwork Routinely Recommended in Vet's Practice
With any older animal (or person), bloodwork should be routinely done before and while taking either Rimadyl or EtoGesic. I find that most people are willing to do this, but many are not. The practice that I work at has been fortunate, and only a few dogs experienced problems. It's good for consumers to be aware there might be potential side effects (with any drug), but in my experience more dogs have had their lives extended due to Rimadyl.

Rimadyl in the UK
"I have read many of the reports on the alleged side effects associated with the use of Rimadyl in dogs. These stories are truly tragic. It should be noted though, that Rimadyl has been used in the United Kingdom for the last 15 years with great success. There is a potential for serious side effects with Rimadyl, but it is small. There is a severe misconception that dogs who get sick while being on Rimadyl are sick because of the drug. That is an unfair and uninformed assumption. Ultimately, the cause of many illnesses will continue to be elusive. To try and pin these illnesses on one drug is just wrong. My information comes from a very credible source: Dr. Stuart Carmichael, B.V.M.S., M.V.M., D.S.A.O., M.R.C.V.S. Professor Veterinary Clinical Studies Director, Small Animal Hospital - University of Glasgow."

Cost of Screening Is a Barrier to Proper Administration of Rimadyl
"I've worked in an animal hospital for almost five years. Every veterinarian I've talked to recommends a full liver and kidney panel (smac,cbc, diff) for 'Senior' dogs. Most pet owners refuse, due to the cost of the bloodwork, which is understandable. However, I would love to know how many of these Rimadyl deaths were due to an owner's refusing to have bloodwork done beforehand. Any medication your pet is going to use should be preceded by bloodwork to see if there are any prexisting liver and kidney problems. If you are willing make the the investment in the drug (which is not cheap), you should really spend the extra money for the bloodwork. Yearly blood panels are also important to make sure the drug is not harming the pet in any way. It's the same rule for humans: if you start using an arthritits medication, your doctor will not okay a refill unless you get your yearly bloodwork done first." (Editor's note: The FDA CVM recommends monthly -- not yearly -- blood panels while a dog is on Rimadyl.)
Kimberly Smola Animal Hospital Inc.

Canadian Veterinarian Reports on Adverse Effects
March 2000
-- "I have read with interest your info and reports on adverse drug reactions from Rimadyl in the US. The product was introduced into Canada in April, 1999; 49 serious adverse drug reactions have occurred to date."
a Canadian Veterinarian

Veterinarian Uses Rimadyl for Own Beloved, Rescued Dog
3/14/00 --
"Shady is my dog. I do not know how old she is. I was called to an emergency involving a stray dog, and there she was, under a parked car, bleeding. I coaxed her out and carried her to my veterinary hospital two blocks away. We gave her IV fluids and treatments for shock, and hospitalized her. The next day, her owner called the animal shelter and described her. He was told where she was, but he did not leave his name or phone number. He never came for Shady.

"Shady was not hurt that badly. She had an ugly tumor over her eyelid, and her face was totally grey. She was very, very stiff and hurt all over. She had a moderate heart murmur, but she was so friendly and quiet, she was no trouble at all. We waited for her owner to claim her, but, after a week, we decided he would not show up, so I took her home.

"I think Shady is probably about 14 years old. She is a retriever mix, apparently spayed, with severe hip dysplasia and aches and pains in most of her joints. She cannot walk without Rimadyl. I have checked her bloodwork periodically, as a pre-anesthetic check before removing tumors, and her health is good. When Shady missed just one dose of this drug, she started limping again.

"I prescribe Rimadyl for my patients who need it. I always offer bloodwork before starting the medication, and recommend rechecking it periodically. Some of my clients choose to have the bloodwork, others don't. In most cases, the Rimadyl is prolonging the life of the dog with good quality and comfort. In my opinion, that's all that matters to a dog. Longer life means nothing if it just means longer pain."
Dr. O; familypet1@aol.com

Srdogs Receives a Message from a Veterinarian; We Wish to Reply
February 2000
-- The following E-mail message was received by srdogs. When we tried to reply, we discovered that the return E-mail address was corrupted. We hope the veterinarian who sent the message will have the opportunity to read our reply, and that our reply will help clarify some of the issues raised in his message.

The veterinarian's message:
"Your list of deaths of dogs on Rimadyl read like something from National Enquirer. I feel you are doing a disservice to many people by even allowing these anecdotal contributions be put on this media. 'AIHA caused by Rimadyl.' 'Eleven year old Doberman paralyzed by Rimadyl.' To what do you attribute the greater number of cases of AIHA (3-4 year old female Cockers) who are not on Rimadyl. The Doberman most likely had a cervical disc problem which would not and probably could not have been successfully treated. I was recently blamed for a 17 year old dog with a brain tumor going into renal failure after I prescribed Rimadyl for hindlimb arthritis. The owners were anxious to blame me after reading your list of totally nonsupported anecdotal list of deaths. If you are determined to allow these cases to be available on your site, please pay for post mortem exams and publish those as well. I am a general practioner and doubt that many clients will be prepared to pay for monthly CBC's and chemistries but they sure are happy when their old dogs act young and happy again when they start taking Rimadyl or Etogesic."

Our reply:
"Dear Dr.:
"Thank you for contacting us. We sincerely appreciate knowing your views on the srdogs website's coverage of Rimadyl. We fully understand your concern and frustration, and wish we were not in the time-consuming, burdensome, and equally frustrating position of providing a public forum on an issue that has created so much controversy and concern among consumers. The issue is of concern not simply because dogs have suffered side effects from Rimadyl; we state repeatedly in our coverage of Rimadyl that all drugs have side effects and that the risks of taking a drug must be balanced against the benefits. The issue has arisen because: (1) consumers have been led to believe that Rimadyl has no serious side effects; (2) information about side effects is not being made available to them when the drug is prescribed: and (3) veterinarians, themselves, in a number of the cases reported, have not been aware of the drug's side effects, contra-indications, or drug interactions.

"FDA guidelines on adverse drug experiences clearly state that an ADE report may be filed when there is a suspicion that a drug is implicated. We are following the same guidelines. Another important guideline we follow, however, is to compare the reported incidents with the potential side effects listed in the Rimadyl product description published by Pfizer. The two conditions you cited in your message -- AIHA and paralysis -- are, in fact, noted by Pfizer as potential adverse side effects in the product description. (They are mentioned under the heading "Adverse Reactions ...... Post-Approval Experience.") We screen out reports that present symptoms other than those listed by Pfizer, such as those we have received in which cancer and heart disease are mentioned. Clearly those could not possibly be related to Rimadyl.

"Our list of 'anecdotal' material is not, as you describe it, 'totally nonsupported.' Many of the deaths and toxic reactions presented in the reports on srdogs have been determined by Pfizer vets themselves to have been related to Rimadyl. We sincerely regret that your clients would blame you for their dog's renal failure on the basis of information on the srdogs website. However, 'acute renal failure' is, in fact, one of the adverse reactions noted by Pfizer in the product description. Both the product description and a consumer-oriented sheet entitled 'Important Information about Rimadyl' are supposed to be given to a client when Rimadyl is prescribed. Thus, you see, the information is available in a source other than the srdogs website and, according to Pfizer's own directives, should have been made available to any of your clients whose dogs were taking Rimadyl.

"Pfizer has ordered and paid for necropsies in a number of Rimadyl-related cases. We would be more than happy to post on the srdogs website any necropsy reports Pfizer would care to forward to us, particularly in those cases in which the necropsy indicates that Rimadyl played no part in a dog's death. We realize that there are very few people who would be in a position to pay for monthly CBCs. That is an idea proposed by the FDA's CVM -- not by us. We felt, since it was an advisory issued by the CVM about a drug that is under discussion on the srdogs website, it made sense to post the information.

"Again, we deeply regret that your clients accused you of harming their dog by prescribing Rimadyl, and sincerely hope that you have been able to repair your relationship with them. We also hope you might consider that any information can be misused, and that it is not the presence of the information itself that is at fault.

Respectfully yours,

The Senior Dogs Project"

Vet-Tech-in-Training Likes Rimadyl; Maintains Clients Do Not Follow Vet's Directions and Do Not Provide All Relevant Drug Info
-- "I work for a vet as a receptionist and technician in training. One thing we see a lot of is not that our doctors are not informing the clients of the side effects of Rimadyl, but the client's refusal to follow the directions. We explain the side effects. After a 5-day sample is given, if the owner wishes to continue the usage, we insist on blood work and an annual blood test after. The test is $32 plus an $11 office fee/blood draw. You wouldn't believe how many clients get angry over this! So they use aspirin. They don't tell us, then they see that aspirin isn't working as well, fork over the $43 and have the blood test. Now, mind you, they don't tell us about the aspirin usage. Ever wonder about some of these lawsuits?

"Other clients have 'several' vets. One will put the dog on prednisone for say, allergies. They come in to us and pick up their Rimadyl. We have no record of pred use nor of the possible usage of another vet 'closer to home'. See where this leads? You wouldn't believe how many times we dispensed a med and the client asks about using it with something else given by another vet! We then have to get the doctor and reissue something else or recommend discontinuing usage of another med. The doctor will relate to us later that the client never mentioned usage of another med while in the exam room.

"We indicate this stuff on their files for future reference and also advise the client to let us know this stuff for the best care of their pet. When the client comes in and asks for refills, we check records to make sure recommended blood work has been done, ask about the dog's general health and dispense it if the dog is ok. Then we have Fort Dodge come into our clinic slamming Rimadyl and the problems. The NSAID/senior animal/pharmaceutical market is unbelievably competitive. These companies will do anything to scare the pet owner. This is how I found out about your site. Fort Dodge reps are using it to lure pet owners from using Rimadyl, saying that their product, Etogesic, is better. Sorry, I don't buy into this because BOTH are NSAIDs. I'm sure they will see the same problems as their product becomes more widely used.

"Most of our clients don't like the extra expense of EtoGesic and prefer Rimadyl. In addition, the clients who have actually preferred EtoGesic over Rimadyl switched because the Rimadyl made their dogs hyperactive, not because of liver problems. If liver problems do show up, they sure won't be getting another NSAID! Both are good meds, in my opinion, and need to be used as directed. The responsibility really lies with the owners of these animals to ensure that the doctors KNOW what meds their dogs have been using, INCLUDING OTC's! I keep written records in a file for my dogs and simply bring that file as well as the bottles of any pills. This way, we KNOW what has been perscribed rather than, 'Oh you know, those big green and yellow capsules.'

"I never realized how competitive these pharmaceutical companies were until I started working for a vet! I have sat through various seminars by Fort Dodge, Pfizer, Muriel (Merck) and others. In the end, you must trust your vet's judgement, ask questions, and document your own pet's health record. This is probably the best advice I can give senior pet owners. My springer, now chasing UPS drivers at the Rainbow Bridge, was on Rimadyl for 5 years. I loved it! We live in a split level house, and he was able to fly all over the house and into our terraced back yard. He lived a full life until he was 13, when he had a stroke, unrelated to Rimadyl usage. If it wasn't for Rimadyl, he would have been a grouchy old coot of a springer in those last years."

A Vet Tech Speaks Out in Favor of Rimadyl
2/5/00 -- "As an RVT and a pet owner, I have to comment. We use a lot of Rimadyl in our office, and have seen one possible toxicity, and that was in a 14-year-old diabetic Lab. Yes, we lost her, but to what? -- old age, complicated by everything? Our office requires blood work every 6 months on all long-term Rimadyl patients, as we do in phenobarb or prednisone patients. With every drug, there can be side effects. For short term use, such as following surgery on a young dog, we prescribe it routinely without any problems. Personally, I use it on an as-needed basis with my 14-year-old Collie. I did learn, the hard way, that an overdose can cause diarrhea, but that is the only side effect I've had with her. In my working Border Collies, I use it, again, on an as-needed basis and have never had any problems. I realize that percentages only mean something depending on which side you fall on, but this drug has helped a great deal more dogs than it ever did harm to. Doctors need to be informed, and in turn, their clients need to be informed, of the potential for side effects, not only of Rimadyl, but any drug. We must realize that many of the dogs that are treated long-term with Rimadyl are older dogs with various and assorted things just waiting to happen to their elderly bodies. We, as owners and caretakers for these dear pets, must sometimes decide on which is better -- movement without pain with a risk of potential problems, versus no movement, no life. I personally will take the risk in my own older dogs for a life free of of pain. Just my Honest Opinion!" Kathy Daily, RVT

Veterinarian Who Prescribes Rimadyl Widely Is a Strong Advocate
January 2000 --
"I am a veterinarian and an advocate of Rimadyl. I am saddened to hear of the dogs who have died from what is believed to be Rimadyl toxicity. Our clinic is a very large and busy small animal hospital. We are Pfizer's second largest account in our state; therefore, we prescribe a lot of Rimadyl. We haven't had any severe side effects to Rimadyl at our clinic. The only side effects we have noted have been GI upset. Those dogs were taken off of Rimadyl and improved quickly.

Side Effects Largely in Geriatric Dogs

"On your website, I read a lot of the cases presented. The majority of the animals showing 'side effects' were geriatric patients, and most of them had already exceeded the normal life span for their breed. It is very possible other problems associated with aging may have been going on. Also, a lot of clients did not report the 'side effects' for an extended period of time.

All Drugs Have Side Effects

"I know that there are side effects to Rimadyl. I know in some cases they may be fatal. However, there are side effects to every medicine given to animals and humans. What are the percentages of severe side effects to Rimadyl? My educated guess would be much less than 1%. Rimadyl has saved many, many more dogs than it has been accused of 'killing.' It has extended the lives of hundreds of dogs at our clinic with severe arthritis and hip dysplasia. Check out the side effects of the #1 and #2 prescribed human arthritis medicine, and maybe Rimadyl won't look so bad.

Conclusions and Recommendations

"I believe Pfizer is responsible for providing veterinarians with better information about ongoing research in the area of side effects. I also believe that veterinarians need to better educate their clients about Rimadyl. Owners also need to contact their vets as soon as they believe their animals may be experiencing adverse reactions. The sooner these problems are addressed, the better the chance of a good outcome."

From Dr. C., DSAHDOC@aol.com

Lengthy Counseling Required by Veterinarian about Rimadyl's Benefits
12/7/99 --
"Part of the reason that I am so upset with your website and its anti-Rimadyl sentiment is that I have to deal with a large number of clients who balk when I bring up using the drug in their OBVIOUSLY painful dog!!! Many of my clients have read on the web how 'terrible' Rimadyl is and are now afraid to use the drug in their animal. I have to spend 10 mins. explaining to them about how safe the drug is in MILLIONS of dogs and how the web has blown the toxic reactions out of proportion. Fortunately, I am able to convince most of them to try the drug when I tell them that, if i was 85 years old and in constant pain and my family refused to let my doctor give me a painkiller for fear it may shorten my life, I would be really REALLY PO'ed.....'I'm 85, I've had a really long life.....now give me the drug'......10 minutes might not sound like a lot....but multiply it by 10 or 20 clients over and over ...The reality that I have to deal with is that dogs don't live forever....a 10 or 12 year old large breed dog is near the end of its life.....that's a fact that I cant change.....and owners want to avoid, but I can help the animal to be comfortable for the time it has remaining and I think that is a good thing and worth the risk that it may shorten its life. I, personally, would not want to live in constant or debilitating pain. I also had a client just stop using the drug in their dog because a friend of theirs read on the web how bad it is for the liver....a week later the dog couldnt walk and stopped eating because of the pain......she told me that she stopped the drug for fear of killing her (old) dog, but now she had a choice to make...keep it off the drug (which was not harming the dog) and let it be in very bad pain, or start it up again and fear a liver reaction....after an hour's worth of counseling, the dog is back on the drug and doing well..... I realize that you present both good and bad reports of Rimadyl in your site, but unfortunately only the bad ones are remembered by its visitors, it seems."

Hawaii's Largest Hospital Touts Rimadyl's Benefits and Lack of Side Effects
5/30/99 --
Great website -- my hospital (the largest in the state of Hawaii) is going to start giving out your website address to every senior dog owner who walks through our doors!   In regards to Rimadyl, I would like to report something beneficial: we have been using Rimadyl extensively for the past two years in our hospital as an anti-inflammatory and as a pain medication.  For clients whose dogs are undergoing elective surgery, we offer Rimadyl as a pain medication drug post-surgically.  In addition, we prescribe Rimadyl frequently in cases of trauma or arthritis.  It is our policy with any drug to cover side effects with owners and to advise of risks.  We also require bloodwork in our senior patients before we prescribe it.  So far, we have sent over 1000 prescriptions of Rimadyl out the door -- and no serious side effects.  We have had occasional reports of gastrointestinal side effects, which could be due to a number of factors.  We have had no cases of liver disease, kidney disease, excessive panting, seizures, aggression, or any of the other anecdotal side effects reported on the page.  As with any other prescription medication, I think that dog owners should know the risks, evaluate with their veterinarian whether the drug is right for their situation, and make an informed decision.   Please post this to your site!" 
Jed Rogers, DVM, Medical Director, VCA Kaneohe Animal Hospital

Advice Appearing on a Veterinary Website: http://www.familyvet.com
5/1/99 --
Regarding Rimadyl aka Carprofen: "I have used this drug in over 200 dogs with only one having any negative side effects, that being liver problems. In general, it works very, very well and I think talk about side effects are overblown. Let's face it: there are side effects for a few patients with most EVERY medication given. I have not seen anything excessive with this drug. I do advise X-rays before treatment, and there are some other options besides Rimadyl."

Veterinarian States Rimadyl Has Fewer Side Effects, Offers Better Pain Management than Any Other Drug
10/27/98 --
"Thanks for representing the opposite view of a drug that has brought relief to many dogs. While there may be some side effects to Rimadyl, there is almost always relief from pain associated with hip dysplasia, osteoarthritis and other pain modalities. Also, thanks to Pfizer and Rimadyl, many more dogs are being cared for with regard to pain management, that were not heretofore. Also, please consider that, before Rimadyl, the medicines used for pain had many more serious side-effects, i.e., phenylbutazone, aspirin, narcotics, etc. While my experience is limited on a nationwide basis, in my locality I have treated hundreds of dogs with Rimadyl and can report only 5 that have had side-effects requiring discontinuance of therapy. No fatalities can be attributed to Rimadyl in my practice. I appreciate the fact that Rimadyl must be used with care and that you represent the need for care and judgment in its use. Thank you for allowing me to share my experience with Rimadyl."

NSAIDS Bring Great Relief to Many Older Dogs
10/15/98 -- "I feel that your website deserves a little balance. I have prescribed Rimadyl and now, Etogesic since they were first available. I have seen marked improvements in most dogs. Without a doubt, they have worked better than any other pain reliever that I have used, and I have used all the ones I know about. I have had one adverse reaction with Rimadyl. It was a Lab guide dog that began to become icteric (jaundiced). After Rimadyl was withdrawn, he improved and is still doing fine. It is possible that one particular pet may have a more serious problem with these medications or any other. However, when viewed in total, these NSAIDS have brought a great deal of relief to many of our beloved older pets."
R. Rabek, DVM <RARDVM@aol.com>