Tuesday, October 12, 2010

Bad Medicine


Here's an excerpt from a beautiful eulogy Romney wrote for Beata. I think our old dog, Tuco, might miss her more than anyone. He’s REALLY old, seems out of it a lot, but when we were going to the vet before she died he was totally engaged and has been very clingy (which is exceedingly odd and not a trait natural to “Mr. Bitter”) since she did not come home.

For the past 9 years (minus one) Beata has been my friend, family, and love. She has never judged me for my poor culinary or film choices – or even been mad when I tell her not to bury her bones in the garden (because she always did it anyway). She never wanted anything more than to be loved and not abandoned. She was the cutest, sweetest, most loving little dog. My heart aches that I will never see her wag her body at me again, or get to cuddle on the couch with her while Edwards is on business trips. Edwards and I lost a vital member of our family last night, and Tuco lost his “girlfriend” who brought him back so much “psych”.

Anyway, this is a health blog so let’s get back to business. I didn’t do my homework on the medications she was taking post surgery, and this killed her. I figured—incidentally with the same rationale I used when I hurt my back and didn’t check on that medication—how bad can a couple of weeks of anti-inflammatory meds be? Bad, as it turns out.

What we have is the Vioxx scandal for dogs. The only reason we don’t hear more about it is that it’s for dogs, though it did make the Washington Post in this article:

Vioxx Debate Echoed in Battle Over Dog Drugs

And the medication that kicked it off, Deramaxx, is like candy compared to the one that killed B, Previcox. When I Googled it on the night she died I was shocked that EVERY SINGLE WEB SITE THAT WASN’T TRYING TO SELL IT WAS A WARNING OF ITS DANGERS. The net is littered with stories exactly like ours, of healthy animals seeing a vet for an injury and dying due to complications with the medication. Some of these pages also contain angry letters from vets (or perhaps pharmaceutical PR people but that’s another story) stating that slamming the medication would only serve to hurt other dogs. Well, at least it might hurt the ones that don’t die.

Being more of the scientific type, I dug into studies. Turns out even Merial’s (maker of Previcox) own studies on the drug are highly alarming. Most that they used were done on three day post surgery groups. In these groups many small dogs died (so it shouldn’t be used on dogs under 12lbs) and many had internal bleeding. Then there were some longer 180 days studies. In these many dogs died, almost all had side effects and internal bleeding. That is the POSITIVE research.

Then there are the FDA reports on drug safety. Here we see how Previcox has become safer through the years. In 2005 and 2006 it was killing over 10% of its users. Now it’s down to just over 1%. This is not a typo. How would you feel if every time you popped some ibuprofen there was a 1 in 100 chance that you’d die?

It’s not like we’re trying to cure an aggressive form of cancer where the patient would die without the medication. We’re just reducing some swelling. So why are vets shilling something almost certain to have side effects with a high risk of death? Even more so, why aren’t there at least strong warnings given to the customers? The answer, I suppose, comes right back around to Vioxx, which doctors continued to prescribe as it was killing thousands of people even though there were plenty of safe alternatives. Okay, that’s not an answer. An answer would be speculative so I’ll let you make one up. The only fact we know for certain is that it happened with Vioxx, it’s happening now with Previcox and Deramaxx, and, for those of you who don’t have pets, it’s still happening with other medications that are killing people.

Ironically that last article showed up the night B died. I will deconstruct it later this week. The point today is to warn you against the dangers of NSAIDS for both animals and humans. NEVER TAKE (OR GIVE TO YOUR PET) ANY MEDICATION THAT YOU HAVEN’T RESEARCHED AND ASSESSED THE RISK. Not even for something that seems innocuous, and not even for one day. Those in the medical field may call you alarmist (they often use analogies like “you aren’t qualified to understand the science”) but I call it being informed. And whether or not your information is “faulty” dead is still dead. You don’t need a degree to understand that.

pics: beata and tuco and, what we thought, might be one of HIS last trips to the coffee house where they were fixtures. mr. bitter is not happy. climbing won't be the same knowing b's not watching out for me.

18 comments:

Amy said...

I'm so sorry for your loss.

elijah said...

People suck. Critters are rad, dogs especially. You'll go crazy with this one. You're probably already there. Why do people treat critters so poorly? Who knows. You make me think we can fix that but I've been here before. The important work is done anyways - you gave Beata a good life. That's our responsibility to our dogs. So cheers to a life well lived.

Anonymous said...

So very sorry to hear about the loss of your beloved pet.

I worked as a tech at a local vet's office. The drug companies would send representatives at least once a week who would bring a buffet and prizes for the vet's and their staff to learn about their product and futher recommend their product. Even while eating and being handed free Starbucks gift cards, we all recognized that we were being bought. FYI.

Sorry again.

Andy Patterson said...

Steve, thanks for this post. I have a Siberian Husky puppy, and as he gets older the list of "required" medications seems to grow. I will be vigilant with my pup. Thanks for helping the rest of us, and scratch Tuco behind the ears. He probably wouldn't tolerate my dog's uber-hyperness, but maybe someday they can meet.

Steve Edwards said...

On that vet office thing, I've dated a couple of pharma reps. Know the drill.

A few years ago I wrote something alluding to this. A doctor wrote back in a stated it was illegal to promote drugs this way and that it would never happen. You know, like doping in sports, speeding in your car, smoking dope. Never.

Lee said...

Hate that your having to go through this - my condolences.

Growing up as the son of a doctor, I remember trips to NFL games and anything else you could imagine, all on the dime of the pharm reps. 2 to 5 minute speeches by a beautiful woman about the benefits of the drug qualified it as "business." No science, no downside, just show. It was pretty kickass through the eyes of a 10 year old.

Luckily, for me and his patients, my dad has integrity. He does his own research, he gets to know his patients, and he encourages them to explore multiple options. But, he's a dying breed. Buyer beware is the best advice out there these days.

Again - sorry for your loss Steve.

Amy Siegel said...

I am so sorry for your loss. In the future, consider Metacam for chronic pain, Tramadol for acute pain if you want to go the Pharma route. Alternative medicines include Zeel for chronic pain and Heel for acute.

I hope you never have to experience something like this again.

Keli said...

Steve-

I am really sorry about your dog. It is hard to lose a member of the family and even harder that you lost Beata in the way you did. I think your email blast was a good idea and a good reminder for all of us who trust our vets and assume that doggy meds are just as safe as people meds.

I am treating my puppy for mange and the first vet I went to sent me home with a medication that can result in death. When I googled the meds I was shocked to see the warnings associated with the drug. The drug information for ivermectin cleary states in bold that it can't be given to certain dog breeds at all as it will result in seizures and death. My puppy came from the Humane Society- she is a mix of some sort and there is no way to tell what breed she is mixed with. My vet expressed no concern or regard to the fact that my mixed breed dog could very well one of the breeds the drug manufactorer says not to give the drug to. Doggy drugs don't come with warning labels or information sheets. It would be nice to see the same information that we get from our doctors, on the vet information.

enjoy your time with Tuco....

Steve Edwards said...

Andy,

What "required" medication do you speak of? There should be almost none. Tuc's never had anything other than the legal stuff (rabies et al) and he's been about the healthiest animal I've ever seen.

Lee,

I'd like to interview your father for an article for the BB newsletter. If he'd be interested please let me know.

Anonymous said...

thanks for the info and sorry for your loss.

Lee said...

I passed along your request, but he declined.

FunFitandHappy said...

Hey Steve

Sorry sorry you lost such a good friend. I have a 10 year old yellow lab, so your post really hit resonates with me.

Andy

J J said...

I keep coming back to this series of posts. We have owned pets for years, early on we had hardly any medical issues with our dogs and they lived past 15 years. Now that we are older and can afford better vet care it seems like our pets are getting sicker with more chronic conditions and dying at a younger age. Your post really opened my eyes and confirmed what I was already thinking, that our vet was knowingly or unknowingly contributing to the steady decline of our last two beloved pets. I had made an offhanded remark to my hubby that it seemed like the old yarn regarding bringing your car to the mechanic and leaving with more problems than you arrived with.
The shocking reality is that we live in a green organic household that provides high quality nutrition to our pet, his medical care is at par with our own. Why is it that his monthly vet and medications cost us almost $200 a month. I remember back when owning a pet was nothing more than a daily walk, good nutrition and annual exams.. What is the problem here..

Ben Woods said...

As a physician and one whose dogs are members of the family, this one strikes home. On a climbing trip recently a friend asked me how it is I work 48 hours straight...I simply responded: fear...fear that what I do or don't do to a patient will mess them up. I'm so sorry for you guys and for Tucco the rat, pressing on with the void left when such an active member of life leaves you like that.

Anonymous said...

Read this and think ....

definley.com said...

http://rockyhealth.blogspot.com/

Rocky, 14 years-old and 40 pounds, took Previcox for three days for a pulled shoulder, March 5th - 7th. He is in otherwise excellent shape, and walks at least an hour a day on walks. Within two days after taking Prevaricox, Rocky lost his appetite and began vomiting. He is normally a voracious eater.

When we took him to the vet's office on Monday, March 14th, because of continued vomiting and appetite loss, his kidney levels had spiked dramatically. The only thing that would explain the change is Rocky's taking Previcox. We have read of similar cases online. The problem is that our vet clinic seems skeptical of this. Therefore, they tested Rocky for Leptospriosis, which they suspected would explain the surge; results came back negative. They asked if Rocky had eaten anything poisonous like a lily plant, which he has not.

Finally, our vet agreed to call, Merial Ltd., an animal health subsidiary of Merck and Company, tomorrow morning, March 18th. But this was only after my persistence all week with both clinic vets. I don't think they want to believe, understandably, that Previcox caused Rocky's renal numbers to spike, leading to his kidney failure and need for round the clock dialysis. We are spending hundreds of dollars a day to keep Rocky alive.

Anonymous said...

PS: I'm sorry for your loss.

Thank you for confirming this. It's a weird world when doctors/vets don't want to look at what is obviously killing their patients, and try to deny findings that are wagging or barely wagging before their eyes.

Our vet yesterday was wearing scrubs with "Rimadyl" embroidered on he chest, another drug that gave our dog ulcers, loss of appetite, vomiting. He developed oral melanoma cancer a month later.

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