Previcox Emails
Before & After Previcox
"Brady"
It all began when Brady, my 7 month old English Springer
Spaniel, began showing mild frontal leg lameness in late April,
2008. April 24th we began a 10 day
treatment with Previcox, which indeed took the pain away but
nearly killed him.
On May 14th when I let him outside
for his late night potty break, Brady
seemed to stumble outside. When he came back in
I did a general assessment of him and
noticed that his gums were alarmingly pale. I had
him sleep in my bedroom that night and took him to the vet first
thing in the morning. By morning he
had begun mild vomiting (no blood).
His initial blood work showed that he was
extremely anemic. When a sample was sent to the
lab, it appeared that his immune system was attacking his own
red blood cells (agglutination on the slides), causing the
anemia (preliminarily diagnosed as immune
mediated hemolytic anemia - IMHA). Knowing that
Brady had been treated with Previcox within days of this event,
my vet called Merial and was told that
this was NOT symptomatic of a Previcox toxicity problem. Brady was then referred to a veterinary internal medicine practice. They retested his blood, found his red blood count (via PCV - packed cell volume) to be about 12% (normal PCV is 35-60%). I was told he was extremely critical and could "decompense" at any moment. They held off giving him a transfusion because even though his heart now had a heart murmur, they felt he was able to compensate - at least for the time being.
He was tested for many things.
He had an ultrasound, his chest and abdomen were x-rayed,
he was tested for tick borne diseases, babesia (a parasite of
blood cells), PFK (an inherited
disease that affects both the field trial and show lines of
English Springer Spaniels), had his urine cultured to
check for a urinary tract infection and
they aspirated lymph cells.
Every test came back negative.
Through consultations with specialists all over the country, we
sent blood to a hematologist at the University of Pennsylvania.
This is where it was determined that
"Brady's IMHA (immune mediated hemolytic anemia) was secondary
to drug toxicity, presumably Previcox."
Merial promised to help with medical expenses, which were
forwarded to them on May 30th (no response as of yet - July 4,
2008).
On June 12, 2008 I took Brady to
the vet for his PCV check. Two hours after I got him home
- he crashed. Among other things, he
began extreme vomiting and some diarrhea. This came
out of nowhere!
The emergency vet said he was suffering
complete organ shut-down, he had spiked a fever, had an
irregular heartbeat - the list goes on. My vet is
"cautiously optimistic" at this point. We won't know for
sure until his blood levels are completely within normal limits
and Brady has been off of all medications for a sustained period
of time while maintaining his normal blood values. Time
will tell - but I'm extremely optimistic.
There are many details I've left out of this history such as
noticing him drinking an unusually large
amount of water which resulted in very frequent urination days
prior to the other onset of more serious symptoms, which
I'm happy to share with anyone if it would be of help.
Will I ever use Previcox or anything similar again with any of
my dogs? Absolutely NEVER!
Dear Mel,
You originally published Brady's story on your Previcox site on July 4, 2008, he was one of the first survivor stories you added. It has been a year since he first developed his symptoms. I thought I would send you this update (much of it was previously published), which I posted this morning to a springer group I'm on. Keep up your good work!
Maurisa
= = = = =
Anniversaries are meant to be celebrated, so I
invite all of you to join me in celebrating the life of a very
special dog who - as of today - is a one year survivor of Previcox
toxicity that nearly took his life. Previcox, like Rimadyl, is a
Cox-2 inhibitor and can cause serious adverse reactions.
Brady was a promising young show dog, only six
months old when he was put on a short treatment of Previcox due to
some frontal leg lameness. He was on the drug for 10 days. His
symptoms developed another 10 days after we stopped treatment.
Suddenly he seemed to be drinking huge amounts of water and was
making mistakes in the house. Then one night he staggered as he
came out of his crate. I did an assessment and found his gums to be
white! I had him at the vet first thing the next morning. His RBC
(via PCV) was at 12%, normal is 35-55%. No signs of blood loss
internally - no blood in the stools, no vomiting, no bleeding under
the skin.
We did blood work-ups which indicated he had
developed an immune mediated hemolytic anemia (IMHA), cause
unknown. His body was attacking his own red blood cells. We were
referred to a board certified internal medicine vet clinic. They
determined that he had developed a heart murmur due to his low red
count and performed a vast amount of testing - ultrasounds, x-rays,
more blood work, etc. I was told very insensitively that he could
"decompense" at any time. Yet they would not do an immediate blood
transfusion because he was not yet crashing. Somehow I was supposed
to understand that I was being told he could die at any moment, yet
they would not give him a life-saving blood transfusion until he
actually began the dying process. He was put on a strong course of
steroids and other drugs in an effort to tamp down his immune system
and stop the blood cell destruction.
Two days later his count was down to 8%. He
received the transfusion along with another barrage of testing.
Nothing came back that pointed to the cause. No sign of tick borne
diseases, nothing unusual in the very high tech ultrasounds or
x-rays, normal cell lines in a lymph node they aspirated, no known
cause of the IMHA. They were made very well aware of his Previcox
treatment, but it was dismissed as the cause - even by these Board
certified internal medicine specialists.
My own vet called Merial - maker of Previcox, and
spoke with one of their vets, who also dismissed it as the cause.
He began to decline. My vet did a bone marrow
biopsy and sent it to the lab. The pathology report came back with
"complete bone marrow burn-out." The internal medicine vets
privately told my vet that this was a death sentence and my beloved
Brady should be put down. Fortunately my vet did not share this
with me at the time - he knew I wanted to keep going because Brady
was just a pup and had a long life ahead of him.
I talked with fellow breeders around the country
who offered their experiences with IMHA. Multiple transfusions
seemed to be the key. I called and spoke with Dr. Jean Dodds who
urged me to contact Dr. Urs Giger at the University of
Pennsylvania. I asked my vet to do so, and he did. We sent samples
to Dr. Giger and it was he who determined that Brady's IMHA was
secondary to a probable drug toxicity. The only drug he had been on
was Previcox, sister drug to Rimadyl.
Dr. Giger told my vet that it takes about six weeks
for a bone marrow to recover and we had to try to keep Brady alive
via transfusions until the bone marrow began functioning again. We
continued with the steroids and added anabolic steroids to the drug
mix. Per Dr. Giger, the anabolic steroids can help prod the bone
marrow into producing red blood cells.
Brady did have multiple transfusions. We also sent
his blood work to the University of Tennessee to determine if his
kidneys were producing erythropoetin - a hormone that is helpful in
RBC production. If he was deficient in this, we could supplement
with a drug. He was normal.
Dr. Giger was correct. In about six weeks time
Brady's blood count began a slow but steady creep upwards. He had
setbacks along the way but he conquered each of them. He was on
massive doses of steroids for months, when we tried to wean him from
the drugs, at times the blood count would begin to decrease, so we
increased the dosage until the blood count stabilized.
His recovery took many, many months, but recover he
did! So today we are celebrating his life, as his horrible ordeal
began one year ago today. The life-saving drugs took a toll on his
developing body, but he is now healthy, happy, and off all drugs.
Merial, while not accepting responsibility, did
eventually pay for part of his medical treatment and deemed it
"research." Why Brady reacted in such a way to the Previcox is
unknown to me. I guess that is one of the mysteries of life
itself. And that is why we need to be so careful about the drugs we
put in - and on - our dogs and ourselves.
Thank you for allowing me to share Brady's LIFE
with you!
Maurisa P.
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