When I was in veterinary practice, we always got REALLY excited whenever the latest veterinary miracle drug made its debut. What made them “miracle drugs” was that they usually managed to hit the elusive sweet spot between providing much-needed help for patients while simultaneously offering something very cool (and usually uber-convenient) for pet parents.
The thing to keep in mind is that all drugs, even the miracle ones, come with side effects. A veterinarian’s job is to weigh the potential risks of a drug against its potential benefits for each individual patient. Sometimes the benefits outweigh the risks, sometimes they don’t.
The newest round of veterinary miracle drugs, like many of those that have come before them, sound almost too good to be true. And of the medications mentioned in this post, all have undeniable benefits when used in the right circumstances. However, not every drug is right for every patient, so it’s important to recognize when the risk of using these drugs may be greater than the reward.
Here are three of the current miracle drugs on the veterinary market that may pose potential risks for your pet.
Miracle Drug #1: Apoquel
Introduced in 2014, Apoquel works by suppressing the immune system of severely itchy dogs. It promised to “provide onset of relief within 4 hours” and “effectively control itch within 24 hours”, and amazingly, it did just that. For dog parents who had watched their severely allergic best friend scratch themselves literally raw for weeks or months at a time, Apoquel was a dream come true. Additionally, Apoquel was marketed as a much safer alternative to corticosteroids, which can cause serious damage to the body when used long-term.
But here’s the challenge: Apoquel works by blocking substances in the body called kinases (specifically ones called “JAK’s”) and cytokines, which are linked to the sensation of itching. However, these compounds are also necessary for the body’s immune system to function properly. JAK1 works to constantly survey a dog’s body for invading parasites, fungus, bacteria, viruses, and abnormal cells that may become cancerous. JAK2 is vital for the production of red and white blood cells and bone marrow.
Whenever you block these kinases from doing their jobs, the body’s immune system can be severely compromised. Red and white blood cell counts can go down, leading to anemia and a weakened immune system that can make the body more susceptible to infections. And without the ability to locate and destroy abnormal cells, the risk of developing cancer can increase.
Apoquel is primarily marketed for patients whose itching is caused by an allergic reaction called atopy. However, since Apoquel strongly suppresses the body’s immune system, if a dog’s itching is caused by parasitic mites in the skin or a bacterial skin infection, Apoquel can cause the condition to dramatically worsen. Some veterinarians have witnessed an overgrowth of Demodex mites (which live naturally in the skin and are normally held in check by the immune system) in dogs on Apoquel, which can lead to a flare-up of demodectic mange. Others have had to discontinue Apoquel in some of their patients due to the development of a condition called bacterial pyoderma, an infection of the skin that occurs from an overgrowth of bacteria.
Apoquel definitely has its place in veterinary medicine. For dogs with severe itching who only need it for a short period of time, it can provide much-needed relief. However, any time you’re using a drug that suppresses the body’s entire immune system (not just the itch), much care should be taken to consider the long-term effects.
Miracle Drug #2: Convenia
Convenia is a long-acting antibiotic that is administered by injection. It’s FDA-approved for the treatment of skin infections, wounds, and abscesses in dogs and cats, but it’s also commonly used off-label for urinary tract and respiratory infections, and after dental procedures.
One injection of Convenia provides up to 14 days of constant antibiotic therapy, without the need for pet parents to give their pets multiple doses of medications at home. Sounds great, right? For those of us with hard-to-pill cats, this sounds like a downright godsend.
But here’s the catch – after 14 days, Convenia doesn’t just disappear from the body. Unlike traditional antibiotics, which the body quickly metabolizes and clears, Convenia stays in the body for approximately 65 days after being injected.
Why this matters is because if a pet has an allergic or adverse reaction to Convenia, there is absolutely no way to get this drug out of the system. Convenia’s own drug insert states that the following adverse reactions have been reported:
- Facial swelling
- Loss of appetite
- Anaphylaxis (a life-threatening allergic reaction)
The drug insert also states “Adverse reactions may require prolonged treatment due to the prolonged systemic drug clearance (65 days).” So as opposed to adverse reactions with more traditional antibiotics, where the body is able to clear the drug within hours, adverse reactions with Convenia are much more dangerous.
The greatest appeal of Convenia seems to be the convenience for pet parents. This leads to Convenia being used in cases where there are safer choices available. For hard-to-pill cats, medications can be compounded into a fish-flavored or chicken-flavored liquid by a compounding pharmacy. Pill Pockets, which are made of a soft and flavorful dough-like substance that can be molded around a pill, are another great option for hard-to-medicate dogs and cats.
Like with other veterinary miracle drugs, Convenia has its place. It can be helpful in cases such as for feral cats who have wounds or abscesses and can’t be medicated on a regular basis, or for older people with feisty animals who simply are not able to medicate their pets. But for most pet parents, oral medications – although they can be more time-consuming to administer – are a much safer alternative.
Miracle Drug #3: Oral Flea And Tick Medications
Oral flea and tick medications for dogs first made their debut in 2014. These typically come in soft, tasty chewables that, once swallowed by the dog, begin killing existing fleas and ticks on the skin within hours, then provide continuing protection for up to 12 weeks. Two of the most popular oral flea and tick meds, Bravecto and Nexgard, are available only with a prescription and work by attacking the nervous systems of fleas and ticks that bite a dog who has these drugs circulating in his bloodstream.
First, let me say there are many people (veterinarians included) who swear by these products and consider them to be very safe. However, I have several concerns about their use. First, I personally believe these medications are routinely overprescribed, since despite being marketed as a miracle product that all dogs should be taking on a regular basis, not all dogs need to be on continuous flea and tick medications.
Additionally, Bravecto and Nexgard (and other drugs like them) are systemic, meaning that once they are taken into the body they are present throughout the entire body. And similar to Convenia, they are also long-acting. This presents the same challenges as Convenia when it comes to the possibility of adverse reactions.
According to information found in the CVM’s Adverse Drug Event database, when given orally, Bravecto had reports of over 70 different types of adverse reactions in dogs, including:
- Loss of appetite/Refusal to eat
- Behavioral changes
- Abnormal blood test results
- Ataxia (lack of coordination of muscle movements)
These drugs also require fleas and ticks to have to bite the dog in order to be killed. For dogs with flea allergy dermatitis (an allergic reaction to flea saliva that causes intense itching), this is certainly not an ideal way to remove fleas.
I personally believe there are safer alternatives to oral flea and tick medications. Although topical flea and tick treatments (liquids or sprays that are put directly on a dog’s skin) still contain chemicals that can cause adverse reactions, because they are placed on the skin and not put systemically into the body, they can be quickly washed off if a reaction should occur.
There are also natural flea and tick repellents available for dogs and cats (such as Wondercide and Diatomaceous Earth) that may be perfectly suitable for many pets, especially in cases where an infestation is mild.
Veterinary Miracle Drugs: Know The Facts
There is no doubt that “miracle drugs” have their place; however, they may not be right for everyone. Any time your pet is prescribed medication, don’t be afraid to ask questions, especially when it comes to potential risks.
And remember, you and your veterinarian are partners when it comes to the health of your furry kids. Understanding all the benefits of a medication versus the potential risks will help both you and your vet make the very best decision for your pet.
Have you ever used any of these medications for your pets? If so, what was your experience? Please tell us about it in the comments below!