Be careful about what you read.
A couple of weeks ago I was reading the Sunday news (yes, I occasionally still read newspapers) and I turned a page to find a small headline, “Trifexis is killing dogs.” This little tidbit had turned up on the internet last summer and as expected the phone started ringing the next day. First, let me say that Trifexis does not kill dogs. It kills fleas and heartworm larvae, and acts as a dewormer for intestinal parasites. Second, let me say that these types of unfounded media statements are becoming more and more of a problem and starting to affect how we care for your pets.
So, lets talk about this and give you some tips on how to scrutinize and act on such statements.
First, we must distinguish between pharmaceutical products and supplements. Pharmaceuticals are medical products used to treat medical problems. They are required to go through a tedious and arduous research and analytical process before being put on the market. Supplements are usually considered homeopathic and are not subject to such strenuous requirements to get to market. However the better companies scrutinize their products in a similar fashion as the pharmas do, voluntarily.
Who is responsible for setting and monitoring these requirements? You guessed it, your government. For whatever reason regulation has become a political hot potato. Drugs are regulated by the Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA). Believe me, without these agencies we’d be back to being sold snake oil at county fairs.
How does a drug get to market? First, it goes through years of research and development. Then it goes through years of statistical analysis as it goes through stages of drug trials. They may start with trials on mice and gradually progress up to trials on actual patients (these are called clinical trials). Very few products make it to the “final cut.” If successful the pharma company applies for a license with the FDA to distribute the product. Often at this point the agency sends them back for more trials and research. Once approved the marketing process begins and in another year or two the new product reaches our shelves.
Is this process perfect?….of course not. Yes, there are some products that have reached the market and later devastating side effects surface. In my practice years I can recall a few examples.
Depo Provera was used in the early 70’s to keep bitches out of heat. It worked as an alternative to spaying. It worked great until we started seeing a huge increase in pyometras (uteri filling with pus) requiring emergency ovario-hysterectomies.
Injectable ivermectin was considered the panacea of horse dewormers on it release. At the time worming was being done by passing tubes through the nostril and swallowed into the stomach. No more stomach tubing and dodging horse hooves! Then the swelling at injection sites were being reported followed by potentially fatal infections at the injection sites.
These two examples led to longer clinical trials to avoid side effects that may surface years later.
OK, so as a consumer what do you do?
First realize that the news media has changed radically over the last 20 years. Many (certainly not all) stories are written without proper analysis. Check the stories out. Talk to us and if you explore on the internet I recommend sites sponsored by well known veterinary schools.
Realize that some of the precautionary claims border on silliness. As part of their research the pharmas are required to monitor all adverse problems that come out in clinical trials. These in turn are required to be part of the adverse reaction list. So, for example, most cancer drugs will have death listed as a potential side effect. The dog/cat has a fatal disease and we are attempting to extend their life. We know death will eventually occur. This does not mean that the drug is the cause of death...the cancer is. So how about Trifexis? A debilitated animal in renal failure may die 3 days after Trifexis is given. In all likelihood it died from kidney failure not a drug reaction.
On the other hand, do not ignore abnormalities when medications have been administered. Drug reactions do occur. Call us with any questionable event, even mild events such as red ears or itching.
Is the system foolproof now? No, it can be abused. Today research is still carried out at major universities. However much research is carried out by pharma. They pump millions of dollars to research a product. They will want to have the drug approved in lieu of losing all that research money. Obviously the chance for corrupted data may exist (lets hope not). So do you want that new drug to be researched by a major university?…..probably. In today’s age of tight budgets, many university research projects are corporate sponsored. There is less chance of corruption, but the potential does exist.
Regardless of your political views, support your FDA and USDA. They’re doing a great job with a limited budget. They’re all we have to protect us against poorly researched drugs. Many times I want to pull my hair out because products are being used in Europe and Canada that we have no access to. They have not yet passed FDA scrutiny. I guess I shouldn’t complain.
Try to follow our example. Unless we are dealing with immediate life saving drugs, our practice usually waits a couple of years before placing a new drug on our shelf. Clinical trials, although good, aren’t perfect. It is not unusual to have problems develop once the drug is being used by thousands of patients. We like to have the ‘kinks’ worked out before we offer it to our clientele.
So to summarize, a lot of what you read, no matter what the source, may be inaccurate. If it involves your pet, please consult us. Trifexis does not kill dogs, complications from flea infestations and heartworms do.
If you want to further research, stick to trusted websites produced by familiar veterinary schools and organizations like the ones listed below: