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Death by Previcox

Rowdy’s Last Vacation

Rowdy Roo at two months oldRowdy- Two years old

"Before administering any medication, know what the side effects are. I learned the hard way." -Mel

Previcox- #10 on list of Dog Poisonings of 2011

Our beautiful, two year old Labrador Retriever named Rowdy is dead. He did not die from the impact of the car that struck him and sped away without stopping* nor did he die from the lacerations, contusions and hairline fractured pelvis the x-rays revealed.

Rowdy died because I violated my number one rule when it comes to prescription drugs, "Always ask about possible side effects before administering." I have preached this for years to others and yet, in my agitated state and wanting to give our dog much needed relief, I neglected to follow my own advice. Please read the following before reading of our experience.

After going to other links suggested in our article, use your backspace button to return to this webpage.

 A Vet's Perspective of Rx Drugs For Animals

NSAID's: What Are They and Why Are They Killing Our Dogs?  

Is your dog receiving the correct dosage of Previcox? Our emails show that many dogs are prescribed doses above what Merial, the makers of Previcox, suggest.

DOSAGE: Always provide Client Information Sheet with prescription. The recommended dosage of PREVICOX™ (firocoxib) for oral administration in dogs is 2.27 mg/lb (5 mg/kg) body weight once daily. For proper dosage in lbs, calculate 2.27 x <weight of dog>. Taken from Previcox dosage information

Also found here: FDA website

Monitor Your Dog for These Side Effects

  • Eats very little food or refuses to eat.

  • Drinks more than the usual amount of water in a short period of time, cannot seem to drink enough water.

  • Vomits, (throws up food and/or water) regularly.

  • Diarrhea, poo looks black, tarry or bloody.

  • Urination (peeing) habits change. Dog needs to pee often and the color is off. The urine may smell unusual or there may be blood in the urine.

  • Lethargic, no energy, lies in one spot for hours without moving.

  • Agitated (restless) or uncomfortable for no apparent reason.

  • Heavy panting or breathing.

  • Cannot walk properly or cannot walk without support.

  • Slow to respond to commands or does not respond at all, seems unaware of surroundings.

  • Seizures- legs go rigid or dog has no control over his body movements.

  • Gums going pale, yellow or grey.

  • Whites of eyes look yellow or jaundiced.

  • Skin changes may occur. Redness, scabs or intense itching followed by scratching and biting of skin. Skin may look like it is burned as a result of a reaction to the drug.

  • Loses weight in a short amount of time.

  • Aggressive behaviour, tries to nip or bite.

  If you would like to share your Previcox experience with us, please submit the following:

  • Photo of your dog
  • Dog's name, age, weight and your geographic location
  • Why Previcox was prescribed and dosage (57 or 227mg)
  • Length of time given
  • Case number from Merial

Send to: mel.k911.biz@gmail.com

Previcox experiencesPREVICOX EXPERIENCES

This is our experience (Mel, K911):

Thursday, March 22, 2007. We were on vacation out of state with our dogs Rowdy and Duke when the accident occurred. The vet said Rowdy suffered a hairline fracture of the pelvis but that he thought he would be okay. He gave us a bottle containing five tablets of Previcox. Previcox (firocoxib) is a Cox-2 inhibitor and is an NSAID (Non-Steroidal Anti-Inflammatory Drug) produced by Merial Ltd., an animal health subsidiary of Merck and Co. Inc. and Aventis, S.A.

The label stated '1 times daily for 5 days'. No information regarding side effects was offered, nor did I have the presence of mind to ask. On this holiday, we did not have access to the internet to research the medication given. Had we been aware of any of the side effects, we may have had a completely different outcome. Little did we realize that with each pill we were doling out death to our beloved Rowdy.

Friday morning, we dutifully began his doses. Rather than give him a whole 57mg tablet as prescribed, we chose to administer half a tablet in the morning and half that evening so he could rest comfortably at night. Prior to administering the Previcox (firocoxib), he had a normal appetite and drank water as usual.

Saturday morning he refused to eat or drink anything, so no pill was given him. Later that evening he seemed to be perking up so again, I offered him food which he ate and water which he drank and drank. I thought nothing of it, nor did I give him any of the medication.

Sunday he seemed even better, alert and wagging his tail. He actually rolled over for a belly scratch from the friend we were visiting. He tried his best to get up but the fractured pelvis prevented him from doing so, so we slipped a long towel around his abdomen and gently lifted him to his feet. We used this method years ago for Gimpy and Jack, two dogs found at different times, both of which had suffered a broken pelvis from being hit by a vehicle. Gimpy had been found on the highway with a pelvis injury so severe that our vet said he would have immediately put her down had she been to the clinic that day. Fortunately for her, it was almost midnight and back then, there were no emergency vet clinics.

Gimpy and Jack both received low dose aspirin (also an NSAID), for inflammation and pain and made a full recovery, living many happy years thereafter. Since Rowdy's injury was nowhere near what Gimpy or Jack had suffered, we opted not to give him any Previcox (firocoxib) on Sunday.

Monday, we began our nine hour trip home. We decided rather than half a tablet, Rowdy would require a whole tablet (as the vet prescribed) to make him comfortable for the long ride. Less than an hour after administering the Previcox, his breathing became labored and many times he rigidly stretched out his neck and legs. Thinking he may have been too warm, we turned down the air conditioning, which seemed to help. When we stopped for a break, he drank more water than usual.

Tuesday came and he seemed very tired. Although he ate and drank, he did not have the stamina to hold himself up. We had to help him walk outside and once there, he would stand in one spot as if he were in a daze. We then had to carry him back inside as he would not move on his own. We chalked up this behaviour to the grueling car ride the day before.

That evening, again trying to make him as comfortable as possible, we gave him a whole 57mg Previcox tablet, his first tablet of the day. By midnight, he was projectile vomiting. Suspect that projectile vomiting is a symptom of poisoning - the body may be aggressively trying to rid itself of a toxin. Drug-overdose patients often experience projectile vomiting. From the article: How to Understand Projectile Vomiting.

Late that night and into the early morning hours, he vomited until he was physically worn out. He shivered uncontrollably followed by heavy panting and then throwing his head far back, he would hold his mouth open wide as if trying to draw in more oxygen. Then all four legs would stiffen out straight. In the early morning hours, he pawed my arm several times in a frantic gesture for help as I lay beside him. His gums were starting to go greyish in colour.

Wednesday early morning, he was immediately taken to our vet and put on an IV. We were told to check on him at four-thirty that afternoon. Meanwhile, I phoned Merial, the makers of Previcox (firocoxib) and told them of the situation. I asked how long until the drug would be completely out of his system and was told eight hours and that there would be "no reach back residual effects" once it was eliminated.

I then went online and started reading about Previcox (firocoxib) and carpofen (Rimadyl), meloxicam (Deramaxx) and other NSAID’s, some of which had been pulled from the market after many dog deaths. We felt certain that with what we were told by Merial, the IV would flush the drug from his system and that evening he would be back to his usual self.

When we arrived at the clinic, the woman at the front desk said we could go back where the kennels were, to see Rowdy. As we moved down the hallway, an assistant stopped us and asked us to wait where we were. I thought perhaps they were situating an animal from surgery into one of the kennels, so never thought anything about it.

The vet approached and asked "Are you here to see the dog that passed?" We looked at each other dumbfounded as I said "No, not MY dog!" He said Rowdy died shortly after noon.

For a moment I was numb. I did not cry or even speak as he led us to the area where Rowdy lay motionless in the kennel. Anyone who has ever experienced a situation similar to this knows the gut-punched feeling that accompanies unexpected bad news. Prior to receiving this medication, Rowdy was a vibrant, healthy two year old dog. How could it be that we were now gathering up his lifeless body to bring home for burial? It did not seem possible.

The next day I spoke with the same person at Merial who had given me a case number the day before. When I questioned why vets were not given the CIS (Client Information Sheet) regarding NSAIDS, I was told they could “Send off for the information if they choose to.” Drugs which can and do adversely affect our animals are routinely dispensed without any information. Why is that?

Would it not be good practice for vets to provide their clients with a CIS before prescribing any medication, thus allowing the owner to make an informed decision regarding their dog’s health and well being? My vet had never heard of any dog having a bad reaction to this medication and said he routinely prescribed Previcox since it was one of the “safer drugs”. 

"There’s clearly a breach between what veterinarians are reporting and what groups on the Internet contend." Quote from Dr. Larry Glickman, professor of epidemiology and environmental medicine at Purdue University School of Veterinary Medicine on ProHeart 6, (an injectible heartworm medication by Fort Dodge) reformulated in 2002 but pulled from the market in 2004 after numerous canine deaths.

In 2008 ProHeart 6 was reintroduced to the market, however it was not reformulated. It only came bundled with more warnings.

Merial's website under the tab Previcox FAQ (this link now takes you to a blank page on their site):

Which dogs should not take PREVICOX?
Your dog should not be given PREVICOX if he/she:

  • Has had (Merial added the word "had" to their literature in 2009) an allergic reaction to firocoxib, the active ingredient in PREVICOX.

As of 2013 they have completely eliminated any information regarding "reaction to firocoxib" and replaced it with the text from the link below:

http://previcox.us.merial.com/about/Pages/use_it.aspx

As a class, cyclooxygenase inhibitory NSAIDs may be associated with gastrointestinal, kidney or liver side effects. These are usually mild, but may be serious. Pet owners should discontinue therapy and contact their veterinarian immediately if side effects occur. Evaluation for pre-existing conditions and regular monitoring are recommended for pets on any medication, including PREVICOX. Use with other NSAIDs, corticosteroids or nephrotoxic medication should be avoided. Refer to the prescribing information for complete details.

An article published in 2006, entitled 'Why is Fido dead? Prescription drugs are killing dogs, too.', named Previcox (firocoxib), along with other NSAID drugs as being responsible for 22,000 cases of illness in dogs, almost 3,000 of which were fatal.

The FDA website also carries this warning: NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment. Ulcers and bleeding can happen without warning symptoms and may cause death.

A Previcox ad notes the following,  "In rare situations, death has been reported as an outcome of the adverse events listed above." Really? Are over 3,000 NSAID deaths (and counting) considered 'rare'?

Reports of adverse and fatal reactions to Previcox abound on websites and blogs. Tragic experiences, one after another are cited while the veterinary world by and large has been lulled into thinking that Previcox (firocoxib) is the panacea for all breeds. 

How many deaths are mistakenly attributed to old age or a 'pre-existing condition' while the real culprit is the prescribed drug? According to Previcox experience emails, gastric ulcers; renal failure and heart failure have been directly linked to this drug.

Other options which may have proven effective for Rowdy were unknown to us. Christie Keith, in her article "What the FDA wants your vet to tell you", shares information as to what vets should be telling their clients and which drugs can safely be used with NSAIDS for gastrointestinal protection.

Below is an excerpt from the article:

"...few vets routinely recommend the use of stomach-protecting drugs such as misoprostol and sucralfate when they prescribe NSAIDs. They instead often wait until the dog has a problem before suggesting gastrointestinal protection, and even then, it’s frequently some kind of antacid, which is the least effective therapy for the damage caused by NSAIDs. In fact, while antacids sometimes makes dogs feel better, they actually have no protective or therapeutic benefit at all, unlike the other two drugs."

Arthritis in dogs cannot be cured, but it can be treated... (Direct quote from Merial's website) Anything can be treated. If arthritis is incurable, why not use safer alternatives which are effective while not being cost prohibitive? Turmeric is one suggestion.

After completing this article, I contacted the out of state veterinarian who had initially treated Rowdy while we were on holiday. His office manager asked why I wanted to speak with him and after telling her I wanted Rowdy's file, she told me the vet was unavailable. I waited until the next week to call again, hoping I could speak directly with him but again, the office manager intervened and this time told me they had no record of my dog being treated at their facility.

Excluding the vet and his office manager, there were four of us at the vet's office that day with Rowdy, so there was no denying he was treated at their veterinary clinic. Do I believe the vet intentionally harmed Rowdy? Absolutely not. He seemed genuinely concerned about his well being. I do believe however, that denying he was treated at their facility, puts them in a bad light and makes me question their motive for so doing. 

Rowdy has now become another statistic, case number 07-18129 in the ever mounting deaths in which Merial claims no responsibility. They did respond with, “We are sorry for your loss.”

Read of Previcox issues from other dog owners

By law, drug companies are required to report adverse effects to the FDA. Anyone whose dog has suffered Previcox (firocoxib) poisoning should contact Merial for a case number as soon as possible. Your report to Merial advises them as to what is occurring in real life cases, not clinical trials and affords them the opportunity to update their list of side effects included with their warning. Merial's website with phone numbers for all geographic locations is:

Contact Merial and report any issues with Previcox

The “Boys”

We had some land that we loved so
And to it often we all would go

As the doors slid open and we watched them run
Our beautiful boys crossed fields in the sun

Rowdy bumped Duke to follow his lead
Duke didn’t mind he followed, indeed

Flushing out a rabbit, it disappeared into thin air
They then tussled with each other, they hadn’t a care

But Rowdy's now gone and Duke wanders alone
A bit unsure of what to do on his own

And now as the doors slide open again
Duke steps out slowly, minus his friend

It is never the same, it never can be
No, life’s not the same without his Rowdy 

 

If your dog is displaying symptoms of Previcox poisoning and you are not able to immediately take him to a qualified vet, consider using activated charcoal to help rid his system of the toxin if it has been less than an hour after the drug was given.

Mandatory Client Information Sheet

More Previcox Information

* Rowdy was not roaming freely about when he was struck by the vehicle. We were visiting with friends in their fenced in back yard when our friend, a beekeeper, noticed his bees swarming and leaving the yard. Trying to keep them in sight, he was looking up while opening the gate and that is when Rowdy who was beside him, darted across the road toward a dog which had been barking most of the morning.

One individual, who wanted to see what occurred with his dog Scamp when Previcox was administered to him, had it tested on his own liver functions. Note: He did not take the drug orally but had a doctor test and compare the results as if he had taken it. Below is his report.

"I got a friend who is a practitioner, to test the last half of the Previcox tablet on me. I am 3 times my dog's weight and the tablet took down my liver function, spleen, duodenum and worst of all was the kidney and gallbladder function, both down big time. Also caused inflammation big time on liver. We first tested my organ functions, then we put the tablet in/on the machine and by putting in the differing organ ampoules again we were able to test the ill effects the Previcox tablet had on my varying organ functions. This as you know had a devastating and frightening ill effects on my organ function. Even more so when taking into account the big difference in Scamp's body weight compared to my own. The results are the same as if I had taken the tablet orally. For a drug that is supposed to cure inflammation we put it against my tester ampoule for cortisol, which I am sure you know is what prevents inflammation. It took my cortisol levels way down as well and this, with me at 60kg (132lbs) on only a half a tablet! No wonder the poor dogs get so sick and my dog at 20kg (44lbs) got so very sick on 2 and one half tablets."

Veterinary Adverse Event Voluntary Reporting (US only)

Revised April 23, 2013