In February 2007, the Federal Drug Administration (FDA) approved the application by Pfizer to market the first drug specifically developed to prevent and treat motion sickness in dogs. Now that Cerenia™ has been available for a few years, some potential issues have surfaced. This article examines the risks of using Cerenia™, and looks at some of the causes underlying the issues. The potential market for Cerenia™ is significant; according to Pfizer’s research in the United States, 1.2 million dogs vomit from motion sickness, and another 2.8 million dogs vomit each year from other causes.That is a potential market of 4 million dogs who might benefit from Cerenia™ each year.
As with any new drug, the true test of how well it is received is the actual consumer experience after it has become available. There have been some scattered reports of pet illnesses, and even death, after administration of Cerenia™.2 In some cases, it may be that a very small percentage of dogs may not be able to tolerate the drug. Consider that although aspirin is widely available, a small percentage of the human population is allergic to aspirin. The same can hold true for any drug with any dog.
In addition, some dog owners incorrectly believe that the drug is a suitable remedy for vomiting regardless of the cause; one popular dog club (www.saintbernardclub.org) even stated on their website: “This first-in-class drug has been proven to be a safe and effective medication that veterinarians can use to control emesis (vomiting), quickly and effectively, regardless of the cause, including motion sickness.” 3
In fact, Pfizer clearly states in their marketing literature that the drug has not been tested as a treatment for dogs vomiting from having eaten poisonous substances. When one takes a moment to think logically about this, vomiting is the body’s natural mechanism to eliminate a toxic substance from the stomach. Unless the substance ingested is caustic, vomiting should generally help provide some relief from the situation; preventing a dog from successfully vomiting up a poisonous substance may force the dog’s body to continue absorbing the toxin.
Additionally, the administration of Cerenia™ is not advised for dogs that may have swallowed foreign objects, dogs with liver problems, or dogs that are breeding, pregnant, or lactating. Additionally, evidence of bone marrow dysplasia was found when treatment was given to young puppies.4 Owners need to be aware of this fact, as it is all too common for owners to share prescriptions between their dogs. A prescription for Fido is not necessarily suitable for Fido Junior.
As background information, as with any other drug developed and brought to market, Pfizer conducted research and clinical trials to best determine the safety, efficacy, and appropriate dosage levels of Cerenia™. The clinical trials spanned seven years and included hundreds of dogs. The studies differentiated between dogs undergoing treatment to prevent motion sickness from dogs with acute vomiting from other causes.
During the trials, none of the dogs given Cerenia™ at the recommended dose to prevent motion sickness died, although there were some other side effects. Most common was hyper salivation and vomiting, at 12.5% and 5.3% respectively. Owners need to understand that the drug reduces the incidence of motion sickness in dogs, but it is still not a sure-fire guarantee that your dog will not vomit. Between the hyper salivation and the risk of vomiting even when treated, it is advisable to keep the usual towels or blankets underneath your dog or in his crate when traveling in the car. If planning a lengthy trip over multiple days, the owner should discuss with their veterinarian the limitations of Cerenia™ ; it is not a drug for daily use. Pfizer recommends a two-day limit.
The drug is also being prescribed by veterinarians in cases of acute vomiting, which was also part of the safety studies conducted by Pfizer. In the acute vomiting studies, a “small percentage” of dogs treated with Cerenia™ for acute vomiting died (4.9%) and some had to be euthanized (1.0%). The dogs treated for acute vomiting were generally dogs already quite ill. Pfizer has indicated that they believe the cause of death was not the drug Cerenia™, but rather the underlying condition or health status of the dog in question. Given this, dog owners should be aware that if their veterinarian is prescribing the drug for acute vomiting, while the drug may be able to relieve some of the symptoms for the dog, the drug is not designed to treat the underlying cause of the illness.
With this information at hand, dog owners have the necessary information to make informed decisions in partnership with their vet as to whether to use Cerenia™, and under what conditions. More importantly, owners should now be empowered to ask critical questions if their veterinarian is recommending the use of the drug in a manner contrary to that recommended by Pfizer.
About the author: Sharon McCuddy is the author of the “Lucky Dog” article series, which includes the above article. In part, the author draws on her experiences as a dog owner, rescuer and dog foster home to provide educational articles in the Lucky Dog series. Readers are strongly encouraged to consult with their veterinarian for any medical related issues, and to use the information provided in the articles as a basis for self-education as a responsible dog owner.