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20. The Real Uncensored Answers About Librela · Senior Pet Talk | for dogs + cats

• Amanda Steffen: No. You are listening to Senior Pet Talk, the show where we combine Western and Chinese medicine to give senior dog and cat parents the knowledge, the clarity, and the confidence to make sure that your pets' senior years are their best years yet. I'm Dr. Amanda Stefan. Let's get started. Hello, pet parent, and welcome back to another episode of the Senior Pet Talk Podcast. I am Dr. Amanda Steppen, and I am excited today because we're gonna talk about a controversial topic. Everyone seems to have an opinion on this topic, and I really want to come at this from my favorite position, which is like I'm biased, right? So I like to live my life in a sense that I believe everyone is doing the best that they can. And that includes, you know, talking about different medications and things like that. There are a lot of people that put a lot of time and effort into these things. And could there be some financial push behind a lot of these products potentially? But I like to think that people are creating these products because they really want to help. So today. That means we're gonna talk about the very controversial topic of Labrella. All right. I already see a lot of comments coming through on this and bring them on, I promise. If good experience, bad experience, whatever it may be, like I wanna know what experience you've had with Labrella, if anything. Okay. What I want to talk about today specifically is going deep into what it actually is. how it actually works, what the studies have shown, statistics on a lot of things, and then personally how I use this product. Okay. So I will tell you overall, I do still use this product. It's just in very specific cases or recommend this product. If I go see a new client who's already on this and they feel like it's working, then you know, we're not going to automatically take them off of it right away. I'm going to We're gonna talk about it. And then as we go through the things that we're doing to help them, we may talk about, is this still something that we need or is this still something that we should be using, you know, down the road? But I typically don't change things right away when I meet a new patient or a new client, because I really just want to look at the whole picture, right? Okay, so if you have spent any time on social media, I am in quite a few ⁓ senior dog and cat Facebook groups. Try to be an advocate in those groups about different modalities and options and things like that. I feel like it's a it's a way that I can try and give back, you know, to to people and to their pets. So I'm in a lot of these groups. And if you have ever been on these like especially Facebook groups, There is a lot of information about Labrella. Everyone seems to have a very strong opinion one way or the other. And there are, I feel like a lot of people just stuck in that middle ground of I don't know what to believe. I don't know what's true and what's not. And I think that's very valid. So we're gonna try and hash some of this out for you today so that you can understand a little bit better, minus just what. Some of the like Facebook positivity or bashing or whatever it may be, like whatever you hear one way or the other on this, I want you to have some knowledge to back some of these things so you can understand it a little bit better. And when someone talks to you about it, you have a basis to say, well, that seems like it wouldn't make sense given what I know about how this works. Or maybe this is something we need to look into. Okay. So. I think overall thinking initially about labrella is here for osteoarthritis. And taking a step back, a lot of pets develop osteoarthritis. It can happen as early as two to three years of age if we have some underlying diseases like hip dysplasia or elbow dysplasia or some underlying congenital reason for that. Or just larger pets can often get this earlier, or even smaller pets that get like an IVDD episode, right? So it's important for us to understand that, you know, 80% of dogs over the age of eight have osteoarthritis. So with dogs living to be 10, 12, 15 years old, like I know they have arthritis. I look here at Molly, if you're watching, sh you can kind of see her feet in this fun little angle that she's got. They sleep in the funniest positions, don't they? I don't know why why she feels like her head should hang off of the dog bed, but you know. And if it's comfortable for her. But I know Mabel is 10 years old. About we think we got her eight years ago from a shelter. And she has been showing me some signs about serioarthritis lately. And I am, you know, we're we're working through some different modalities and things to help her out with that. But I know that she's got some arthritis. And I I'm becoming hyper aware of different ways to help her and how to monitor her to see is she in pain right now or is she not? She's a very active dog. So she likes to like rip around the backyard and have a good old time. And if she's not doing that, then I know, or if she's hesitating, especially when she first gets up in the morning, she's seems a little crunchy and uncomfortable, then you know, I'm keeping an eye on that. And at this stage in her life, I am not in a place where I would reach for something like Labrella, but let's talk about why. Okay. So when we're talking about Labrella, the actual name of this drug is BedinvetMad. It's very I I'm sure it's different than that, but we're just gonna call Labrella for now. It all kind of sounds like Harry Potter spells, anyways. So This is what's called a monoclonal antibody. So this product is basically a protein that has been created in a lab. So it's a lab engineered protein. And the purpose of this is to bind to one single target cell, right? So we're binding to the specific protein in the body. The specific protein that Labrella binds to is called nerve growth factor. So, nerve growth factor is a protein that is a key in signaling pain. And it's found in elevated levels in the joints of dogs that have arthritis. Now, so by binding this, it's going to reduce pain signals traveling from the joint to the brain. So literally the best way to think about this is Laborella blocks pain. It blocks the pain pathway. Now, I think important things to say about that is it is not decreasing inflammation in the joints. It is not actually restoring any of the cartilage damage or joint damage that's happened, right? So this is truly just a product that blocks pain. And that can be super helpful and fantastic for certain patients. But that is part of the reason that is not one of my first or even first like. set of options that I use for pain because I really want to get to the source of it. And so it's not going to work even the way that like an anti-inflammatory. So like an NSAD, like maloxicam or galloprant or a carghanity of those types of things work. They actually go in and reduce inflammation, right? So they they target and bind to things that actually reduce the amount of inflammation and swelling that's going on in those joints. Labrella is not targeted to do that. That's not its purpose. So it's not gonna slow, repair, or modify the underlying joint disease, right? All right. So Labrella is administered as a once-a-month injection under the skin. It's dosed based on weight, and it's approved for dogs of the age of one. Okay. So I just want to clarify this drug came out ⁓ five or six years ago, but this is not. A new concept. There has been a drug around since like the early 2000s for humans that was in trials that was a nerve growth factor binder monoclonal antibody. Okay. And that was called Eli Lily. So this product was in development for a long period of time. The trials starting in 2010. Actually, showed a really good response for pain relief in these guys. The problem came in where they also got this condition called rapidly progressive osteoarthritis. And that is essentially this unexplained severe joint destruction that starts to happen. And it required people to need total joint replacements. And that is devastating, but also very Possible for us to be able to do for people, total joint replacements in animals gets a lot more complicated and expensive. And there's a lot more that goes into that conversation. So this can make things a little difficult. So the FDA essentially placed a hold on the studies and on this drug back in 2010 when they noticed that rapidly progressive osteoarthritis that was happening, right? So they lifted the hold after a couple of years. And then they continued their trials. That rapidly progressive osteoarthritis never fully went away in these trials. So in March of 2021, the FDA arthritis advisory board basically said the risk to positive on this, even though there were small percentages of people getting this rapidly progressive osteoarthritis was not worth it. So they basically ceased all potential for this product in human medicine as of right now. The trials showed, I think there was about 11 out of 998 patients on the highest dose of that drug, and three out of a thousand on the lower end of the dosage range developed this rapidly progressive ostearthritis. So I do want to point out like this. It is a real thing that we need to be aware of, but it was not a large percentage and even smaller in the lower treatment groups. The other thing that's important with this to know, because we're going to talk about it in dogs, is that this the group that tended to get the rapidly progressive osteoarthritis was a group that was also on an anti-inflammatory. So these patients were on chronic NSAIDs. Which is common because they're in a lot of pain. So they're on some other chronic anti-inflammatory. And then they also developed this rapidly progressive ostearthritis when used in conjunction. So that is important information to keep in the back of our head for the conversations going forward about the studies in dogs, right? In traditional Chinese veterinary medicine terms, basically we talk about blocking pain signals. But if we're not addressing underlying disease, essentially B syndrome in dogs and cats, then we're not really treating it. We're not resolving the pattern. We're just symptomatically relieving those things, which isn't wrong. But at the same time, there are a lot of things we can do to actually treat the problem as opposed to just covering it up, right? So When we actually go down in there and we're trying to treat that, you know, in an integrative standpoint, I like to add in more things like acupuncture, PEMF therapy, weight management, appropriate supplementation, these types of things first before we start to just want to cover the pain because it's so severe. And we do get to that place with a lot of these guys where we just need to kind of cover up the pain because we need to make them feel better. But I don't think that's a lot of times early in this process, right? So the second thing I want to talk about is does this product actually work? So I'm gonna talk through some of these studies. There's gonna be a lot of numbers involved. Just try to track with me here. Okay. All of these things can be found at your own devices if you would like to, but this is the data that I pulled. There were some studies and the Original a study that basically approved this product being used was a almost 90 day, it was 84 days, and it was a masked placebo controlled study. That is important because we always want to have studies where there's people don't know about what group their pet is in. When we have a placebo, too, to compare that against, that's really helpful. So the problem comes in where forty percent of pet parents actually from a placebo group felt like their pet improved, right? So it's important for us to be ⁓ have things that we actually measure and to be able to quantify for that placebo group because there can be some false thoughts of improvement with that being said. So there were I think 270-ish dogs. There was another study in Europe done that was like 280 dogs. And this was basically like the basis for approval for this. It did show that it was effective and helpful in that study. And that was what created this approval process going forward. And then there were a couple of studies done with pushing it head to head against anti-inflammatories. So there was one study done that looked at it against maloxicam, which is a an anti inflammatory that we use. And they actually looked at changes in the canine orthopedic index scale, which is like a validated owner reported measure. So we're looking for actual tangible values that are changing. And that's really important to know. Essentially, between the Labrella and the Maloxicam, The studies showed that there was a little bit better improvement with Labrella, but not what we would consider statistically significant, meaning that it showed enough to actually scientifically for us to say that it's substantially more than the maloxicam group. Okay. The safety side of that study is actually very interesting because it showed more adverse events in the in said group, so the meloxicam group. Had 17 reported side effects, and the Labrella group only had four. Most of them were GI related. There were also some musculoskeletal, neurological, skin, and behavioral in the maloxicam group, and the Labrella group showed musculoskeletal, skin, and systemic changes. So there were actually more patients in the anti inflammatory group that had side effects. Than in the Labrella group. And this specific study done of about 190 dogs. 52 of them were in the Labrella group and 49 were in the Maloxicam group. Okay. Then we looked at it head to head against Galliprant, which is another anti-inflammatory that's a little bit safer, in my opinion, and more specific to osteoarthritis pain. I really like galloprant if it works for a patient because we can often use it in our patients that have potential GI problems with. Other NSAIDs or don't do well with it. It also doesn't have to be given with food, which is nice. So, and it's once a day, which is really nice. So, looking at it head to head versus Gallup Rant, they did use force plate analysis, which is again, it's important for us to use a validated tool to actually inspect this, right? So looking at this, we did have a success rate of About 68% in the Labrella group versus 56% in the Galliprant group. So it did show a an increased improvement, the Labrella over the Galliprant. In my opinion, not substantial enough for me to choose Labrella over Galliprant initially, but because I still like the idea that we're actually treating the inflammation. And then let's add in some other things to that galloprant to help, right? Then we are looking at it compared to quality of life. So there are some validated tools that have been used in dogs and cats. And this is just kind of saying, like, does it help quality of life in a controlled study? Those studies basically show that yes, it does improve overall quality of life in most of these patients that it was given to. So I think it's important from an integrative Eastern standpoint to look at this too. Because a patient that, if we're talking about traditional Chinese veterinary medicine, a patient who is able to move more freely when they have less pain associated with it is going to have less stagnation, less of that qi and blood stagnation and more circulation in those things. And we're actually going to have better muscle maintenance if we don't use it. ⁓ we lose it, right? So if they're able to move more freely, they're able to move their muscles a little better and activate those muscles and build muscle and maintain muscle. And we can kind of slow that deconditioning set spiral that happens with untreated chronic pain drives. So there's also this like ramp up of chronic pain, and often it can be really hard to get in front of that. So when we are talking about this continuing to move them and make make them comfortable and maintain their muscle, we're also helping to combat that kind of ramp up of pain that happens and hopefully help get in front of that too with appropriate pain control. But this can be another component of that. Okay. Now is the part that a lot of people have questions on, these safety studies. So I'm gonna be reading a little bit of these like studies and things because there's a lot of data to it. But The FDA Center for Veterinary Medicine issued a formal dear veterinarian letter, basically after completing an evaluation of all these adverse events. And they said that there were adverse events like ataxia, which means a wobbly gait, seizures, other neurologic diseases like paresis, which basically means a decreased ability to move the limbs almost to paralysis and recumbency. There was also urinary incontinence. There was polyuria, which is increased urination, and polydipsia, which is increased drinking. In some cases, death, including euthanasia, was reported as an outcome to Labrella. Now, as of 2024, the FDA's database held about 3,600 adverse events reported tied to Labrella. It is important to look a little bit at the timing of these things. And I say that because of something like a patient that I saw. This patient's name was Ryder. So with Ryder, Ryder came in a week after getting a Labrella injection and we diagnosed Ryder with heart-based hemangiosarcoma. Now, I do not think for one moment that Labrella caused this dog to get hemangiosarcoma of their heart. And you may disagree with me, and that is okay. However, Himangosarcoma, it grows fast. I give you that. It does not grow in a week. So although we can say based on the fact that he had just got the Labrella injection, then technically we can report it as an adverse event. When we look at it overall, is not something that happened in a week, right? Ryder went in. To get the Librella injection because he had started to slow down. He was seeming like he was getting exercise intolerance. He wasn't moving around as well. He wasn't eating as well. And without chest x-rays or, you know, a cardiologist work up, blood work was normal. You wouldn't know that Ryder had a tumor on his heart. Again, blood work does not show. Cancer most of the time in our dogs and cats. So without like a full body scan, we would not have known that Ryder probably had this tumor brewing before he was given this labrella. And maybe that was actually the cause of him having all the symptoms that he was having, right? But then he gets this injection and then he feels really good, even though he has this heart-based tumor. He's like, ⁓ my gosh, I feel good. I'm gonna run. I'm gonna do the things because my arthritis is under control now. So then he tries to run out in the yard in the 90 degree heat and he collapses. And then we have the conversation of he has this heart-based tumor. And in a way, it can seem like that was potentiated by this injection. And I don't think for a minute that the injection caused this. However, I do think that the injection making him feel a lot better and move a lot more can amp up the signals and the signs that we notice, right? And can make his heart beat faster. And if his heart is surrounded by fluid and cannot beat faster, then it can make these things occur or seem like they're occurring in correlation to the librarella injection. So I do think it's important to take those types of things into account, right? So that being said, when we're looking at these adverse events, two thirds of them were reported within a week after the administration and 30% within the first day, 70% signs followed during the after the first dose. So I do think it is very important to talk about these side effects. And I do think they definitely do happen. I think we just have to look at the overall picture, right? In the end, you have to make the decision that you are most comfortable with for your pet. And I know that's really hard. So I think it's important for us to just have as much knowledge as we can. Not saying that this product is right or wrong for anyone, just we need to know. So 30% of these cases had no concurrent use of other products. So meaning that 70% of these patients. were on other medications concurrently for other problems going on, right? Whether that was arthritis or something else, cushions, you know, diabetes, whatever it was, they were on another product. So it's hard to say that just the Labrella was the thing that could have caused the changes that happen. Okay. So if we're looking at it to scale from 2021 to 2024, there were 18 million 100,000 doses given globally. The rate of side effects reported was about 10 events per 10,000 doses. So when we look at the numbers on that, it's still we still don't want 10 events, right? But 10 events per 10,000 doses is still pretty minimal. So This is the reason that I still do use this product because we do look at the risks and the benefits, but also the adverse events are very low in numbers and percentages. And it is something we have to take into account with this with patients that are really painful. So most of the common signs actually just said like rate of efficacy. So 1.7 out of 10,000 said just it didn't work, which is a, you know. Sucks for your pocketbook, but not that terrible, right? We'll take that. And then following that was increased urination, increased thirst, urinating in odd areas, ataxia, anorexia. And then we do go into like lethargy, death, and vomiting following those things. These are all classified as rare, meaning one to 10 per 10,000 doses. All right. It is important to keep into account those types of things, right? So The musculoskeletal signals. So looking a little bit more at this, there was a study done that did find ligament and tendon injuries, polyarthritis, meaning arthritis in multiple joints, fractures, neoplasia or cancer in the bones, and septic arthritis were reported nine times more frequently in these labrella-treated dogs. We do have to look at the caveat of this was 19 patients. So this is a very small subset of dogs. All right. The most of these dogs were also concurrently receiving NSA therapy. So that is another thing we have to think about. We know that concurrent NSA therapy can worsen this. So that is just something to keep in mind, too. I do think that. And we do see that there are cases where patients get this rare phenomenon of this rapidly progressive osteoarthritis that happens on the other side of it. That very much happens. It is very rare. And I think a lot of our thoughts on how this worsens things is kind of this chicken and the egg conversation, right? So these patients, they're in a lot of pain. And they don't want to move. And their joints are all tight and their ligaments are tight and their muscles are wasted and their muscles are tight. And then we give them this injection that blocks all that pain. And then we don't talk to people appropriately about how there is a back to play and a back to movement protocol with Labrella. We don't just give them this injection, they feel so much better. And then we just let them start sprinting in the backyard when they haven't sprinted. You don't just get off the couch and run a marathon. You get off the couch and you walk a mile and then you progress your way up, right? So I think it's important for us to realize there is an important protocol that needs to be discussed anytime we dose Labrella for the first time to say, Hey, we do need to make sure we're monitoring how much they do. Like we need to slowly move them back into doing these things. Because I Believe, based on what I know, that these patients will get really excited and then they run around. And they can do things like tear a ligament or, you know, have an ACL tear. They can pop a hip out of place. They can have all these things that happen and these injuries that happen that I don't think are actually from the libras physiology. I think it's just from the fact that they feel so good and those ligaments are not great. And then we're we're causing these things to happen because they're moving too much. Right. So that is an important distinction to make as well. We really need to use this wisely and appropriately and have the appropriate conversations that we're supposed to have before we just give this and say, great, go, go ham. It's important to make sure we're having those appropriate conversations. So the UK's veterinary medical is completing an in-depth analysis on safety. This started in ⁓ February 2026, but is this specifically evaluating like death arthritis with faster than expected progression and then different things like that? So they are that is an ongoing study that is happening. There are lots of ongoing studies about this product because it does have a lot of controversy with it. So we are going to be continuing to look at those types of things, right? All right. So I think regardless, when we're looking at these like potentially unmasking these latent diseases that have been lying dormantly, you know, are we uncovering neurologic diseases that have been there and kind of dormant? I had a acupuncture patient that I used to see named Bayer. And Bayer, he got the Labrella injection. It was newer. We were really excited about it. Got the injection. Unfortunately, he had a fever. And vomiting ⁓ GI signs for two weeks following that. So we discontinued it for him and and never did it again. But he also had some like chattering that started to happen with his teeth. And, you know, with him, the question was, did he have some underlying neurologic disease that we didn't know about? And we kind of unmasked that by using this product that attaches to a nerve growth factor, right? So that can be a really interesting take too. Are we potentially unmasking these? diseases that may have been there, but we're we're making them progress faster or we're kind of uncovering them and bringing them to the forefront or something along those lines, right? So all of those things are really important to think about when you're deciding whether Librella is an appropriate choice for your dog or not. Have you ever left the vet with more questions than answers? And then you drive home and you go straight on to Google. Yeah, I hear that a lot. And honestly, it's exactly why I created my senior pet virtual consultations. Imagine we have 45 minutes where we go through everything, your pet's full history, their specific challenges, their daily life, no rushing. We're gonna cover nutrition, integrative options, whole modifications, and quality of life. And I send you a personalized plan after so that nothing slips through the cracks here. But don't just take my word for it. Chelsea called it a senior pup therapy session and said she felt so much better afterwards. Adiba got recommendations her own vet had never thought to suggest, and Denise said that the consult was incredibly informative and helpful, giving her many options to help her dog Loki feel better. This is the conversation that your senior pet deserves. And honestly, The one you deserve too. The link is in the description. I'd love to help you. I think that this is part of the reason that I really focus on, you know, blocking pain, but also helping with other things. So also stabilizing their joints using things like rehab therapy, weight management, exercise control, acupuncture, these types of things, what we call a multimodal treatment approach is extremely important in treating these things because it's not usually just one component. Right. There's I have rheumatoid arthritis. I don't just treat that with a pill. I treat that with a multimodal approach of certain supplementations, certain herbs, collagen therapy, diet factors, you know, cutting back on certain things in my diet and medications. And I can say that I have not progressed in my disease and I have done really well. keeping my disease at bay by using all of these different modalities and and listening to my body, right? So how do I actually use it? This is the fun part. I get to tell you my opinion, which is always something that gets gets other people's opinions, right? So please tell me. I really want to know if you absolutely disagree with me. That is cool. I'd love to hear why. You know, I if you want to know more, I'd love to talk more. You can find me and we can have more of a chat as well. So, my thought process on labrella is I do use it. I have used it in many, many a dog. And I have seen very wonderful results in many dogs on Labrella. I would never withhold librella from a patient who has no other choice at this point, who is in pain. And we have tapped out all of our other resources. Why would I withhold something that could help? Here's the conversation that I always have with people. It's not my first choice. So I am going to recommend other things first that I feel like are safer. So can we do acupuncture? Can we do home changes? Can we do herbs? Can we do maybe even NSAID therapy? Or are there other medications that we can do? To help with that, like subduketamine injections. Like, are there other things we can do to help first at a quine, those types of things? Or are we at the place now where we have done all of those things and we are still in pain? And my highest tier for patients is comfort. You know, I think one of the most important parts of quality of life for these guys is. That I want them to be comfortable as they can be during their life. And it's not a good life if they're living it in pain, right? So we want them to live as long as possible, but yet we also want them to live as comfortable as possible. And I think for some of these guys, that means something like Labrella can be really helpful to block that pain when it gets just so bad. I have had many a patient where We are at this place where we just say, we are in a lot of pain. And I don't know that we can do there's there's nothing else we can do for this patient given their background. Maybe they have other comorbidities that make it not okay to do other treatment modalities. Then we're gonna talk about Labrella and I'm gonna say, look, these are the risks, these are the adverse effects that have happened. We know that these things are rare, but they do happen. And this is a risk that we would have to choose to take, just like putting anything into our body is a risk. Anything a food, anything is a risk, right? I always say, like, I can eat a peanut butter sandwich and it's actually really good for me and good protein. And because I'm vegetarian, like it helps me a lot, right? And then my husband can eat a peanut butter sandwich and he would die. So there's a difference in these things. Anything we put in our body can have an effect. But is it worth it? At the stage that they're in. And I would never withhold something from a patient because of these potential side effects. We would just have a very informed conversation about it, as well as an informed conversation about how they're going to need to get back into play afterwards and monitoring things that we need to do and everything like that. The wonderful thing about what I do is that my clients have my Personal cell phone number and they're able to contact me. So I am able to do this in a little bit more of a one on one fashion, which is really nice. Okay. Things like, you know, there are just a lot of other modality options. I have a patient that I met with on a virtual consultation, Betty, and Betty is this precious little, little scruffy dog. ⁓ my gosh, she's cute. She came to me because her mom was noticing she was having some urinary accidents. We talked about, okay, well, what could be causing this? She, you know, a lot of times patients don't have good core strength as they get older, just like older women. So really working on that core can help a lot of these problems. We went over a couple simple rehab exercises and some other modalities in her complete case and Her mom reached out to me a couple of weeks ago and said she has not had a single accident since we had our consultation and I implemented these things. And she loves her PT exercises. She bothers me to do them. And that is so common that people tell me that once they start implementing these things. So there are a lot of things we can do before we need to reach for certain things like medications. But when we get to this place that we need it, we need it. I talked with someone in a virtual consultation who has been in my world for a while on social media. And this is Robin. She has a dog named Jake. And Jake was just in so much pain. Jake was an older boxer and he just had a lot of chronic pain issues. And she was really hesitant about Labrella because she had read a lot of the controversy. And, you know, we really talked deep about it. And we just said, I think it's worth trying. And Jake got another two years of good life from being on Labrella. He did so much better on that product. And if she hadn't had the opportunity to have the consultation with me and really get the unbiased opinion, I don't know that she would have done it. So I think it's really important to just have open conversations. Think as veterinarians, that's a huge part of what we have to do. And I think We just have to be curious about people's reservations and also really be upfront about all the all the things that go into this and what the studies actually show. Because I think you can definitely be feared one way or the other easily. And that's why I think it's so important and a pillar of mine is knowledge. Because the more that you know, the more informed of a decision that you can make for your pet. And we all know how hard it is as a senior pet parent. To make these decisions because we know that we have to make a call and we have to put something in or on their body. And we can't take that back until it wears off. So it's a really hard decision to make. They can't tell us how they're feeling, and that makes it so hard. They can't make these decisions. We're their parents. We're taking responsibility for them when we're making these calls. So I think it's important to try and help as much as we can as veterinarians to make this an easier transition and make the most informed decision possible. And the more you know, the more comfortable you are. So I hope that this podcast gave you more information today about Labrella. I would love to know any of your thoughts about it. I think main things to take away from this is it doesn't actually treat arthritis or slow it down, but it does block pain. And if we're at that place, I think it's really important to look at potential for this. It has very good efficacy data. It works better than often NSAIDs do, which is something to keep in mind. And as far as blocking pain, again, NSAIS, I like better for actually treating the arthritis in a multimodal treatment protocol, but it is something that does a good job at blocking that pain. And a lot of these guys who do have adverse reactions have them because of being on NSADS concurrently or potentially because they're also on NSADS concurrently. So I think it's really important for us to. Think about that when we're prescribing this? Are we gonna stop and sets when we try it or what what's more important? Right. And then there's ongoing studies in this. I know studies can be somewhat controversial because often they're funded by companies. But honestly, if you think about it, who else is gonna fund it? You know, ⁓ the person who has the most invested in something is the person who's paying for the product. So it's just making sure the studies are done. In a placebo-controlled, double-blinded, ideally using appropriate factors to determine if their efficacy is good or not is important. All right. So if your dog is on the umbrella or you're considering it, or you want to you want help talking through all of these things, that is the kind of information that I'm here to give you. Comment down below. Find me on my social media or at senior petconnection.com. We can talk more. I have virtual consultations always available. I have a program where I'm in there once a week talking with pet parents. And there's just a lot of ways that we can make these really well-informed decisions together. And I want to be here for you for that because that's what I wish I had with Floyd. And that's why I created this entire community in this space. So I know that you were doing the best job with the information that you have in front of you today. You are a good pet parent. And I just want to commend you and ask you to take a moment to take a big deep breath and know that you're doing a really good job. Okay. Thank you for being here with me today. Thank you for listening. And as always, thank you for being a part of this community. That's it for today. If this episode helped you, please leave a review or rate this podcast so we can get the word out to more pet parents who need to hear that they are doing a good job. And if you're interested in working more with me, you can find me on social media or at senior petconnection.com because we all need to stay connected. Remember that you are doing a great job with the information that you have in this moment. And I am just here to give you more of it. See you next week.