Updated November 16, 2023
For many years, canine arthritis has lacked major breakthroughs, despite the tremendous need for better therapies. Now, in 2023 we are witnessing the appearance of a whole new class of treatment.
These are exciting times, but we also need to be cautious. No treatment will work on every dog, and after initial overexcitement, some new products end up being major disappointments. However, with Beransa there is real hope for dogs that we have a new and effective tool to improve their quality of life.
What is Beransa?
Beransa is a trade name for bedinvetmab, also called Librela outside of Australia. It neutralises nerve growth factor (NGF), which has been shown to be involved in the perception of pain. As a monoclonal antibody, it has the potential to be highly specific to its target, and block it almost completely.
In Australia, Beransa has been registered for the alleviation of pain associated with osteoarthritis in dogs.
How Well Does It Work & How Quickly?
In our clinic, Beransa has quickly become the number one treatment chosen by our vets for new patients with arthritis. This has been based on a number of factors:
- A very high success rate, interestingly higher than in the trial featured below
- Minimal to no observed side effects, especially compared with traditional anti-inflammatory drugs
- A similar cost to other treatments, especially in larger dogs
What does the evidence say? The results of a single placebo-controlled study conducted by the parent company are shown here and referenced below.
They show that around one in two dogs show benefit after a month. Like with all arthritis treatments, there is a large caregiver placebo effect, so it is important to stay as realistic as possible about its efficacy in each patient.
How To Use Beransa
Personally, I believe the study shown here and our clinical experience are enough to recommend trying Beransa in the right dog. However, I also strongly believe that we should not forget the other tried and trusted remedies for arthritis in dogs.
This is especially because Beransa only targets pain, not the underlying disease process. Now make no mistake: treating the pain is the most important thing, but it isn’t everything. If we add the treatments known to slow down the arthritic process, our dogs should have better function in the years to come as well as right now.
In particular, I encourage all dog owners using Beransa to at least continue the Hills j/d diet and regular pentosan injections. Both are extremely safe and can slow the degenerative process.
Beransa Dosage & Frequency
Beransa is given at a dose of 0.5 – 1 mg/kg by subcutaneous injection. It comes in a variety of vial sizes to cater for dogs of different weights. If desired, the dose is repeated every month. It is generally recommended to try at least two doses before deciding whether it is effective enough.
NGF is important for foetal and juvenile development. Therefore, Beransa must not be used in breeding, pregnant or lactating dogs, or those less than 12 months of age.
Human Health Risks
Similarly, pregnant women, women trying to conceive, and breastfeeding women should take extreme care to avoid accidental self injection or needle stick injuries. To be safe, it is best that they take no part in giving the injection or even holding their pet.
Just to be clear, a treated dog poses no risk to humans.
Beransa Side Effects
Reactions such as swelling and heat may occur at the site of injection, but these seem rare. Hypersensitivity reactions are also possible but appear more common in the cat form of this drug, Solensia.
Our experience with monoclonal antibodies like Cytopoint shows us that they are much safer than traditional drugs like anti-inflammatories. This is because as naturally occurring proteins, they require minimal metabolism or detoxification by the liver or kidneys. However, until there are studies of their use with liver or kidney disease, caution is still advisable in these dogs.
Beransa appears safe when used in combination with other drugs, and at the time of vaccination. The only concern with using multiple treatments could be that if an adverse effect occurs, you may not be able to identify the cause.
How Much Does Beransa Cost?
The cost in 2023 for a single injection of Beransa is between $100 and $130 depending on the size required. This is in the same region as the higher price anti-inflammatory drugs.
Beransa or Librela may not be a silver bullet, but just having another option is a great blessing. Our experience so far is that for some dogs, it maintains their quality of life when other choices fail. It can also be used when other treatments aren’t safe enough to use.
Anyone who has an arthritic dog knows that we still aren’t doing enough for them. The development of monoclonal antibodies brings us just one step closer, and just might give us more time to enjoy our lovely old dogs.
Therefore, talk to your vet about whether it might be good for your dog.
References
Corral, M. J., Moyaert, H., Fernandes, T., Escalada, M., Tena, J. K. S., Walters, R. R., & Stegemann, M. R. (2021). A prospective, randomized, blinded, placebo-controlled multisite clinical study of bedinvetmab, a canine monoclonal antibody targeting nerve growth factor, in dogs with osteoarthritis. Veterinary anaesthesia and analgesia, 48(6), 943-955 Full Text
Kronenberger, K. (2023). In dogs diagnosed with osteoarthritis, how safe and effective is long-term treatment with bedinvetmab in providing analgesia?. Veterinary Evidence, 8(1) Full Text
Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.
My 11yo American staffy has 4 Beransa injections for a cruciate ligament tear and arthritis.
Amazing results! Taking our girl from a 3 legged in pain dog to running, playing again and happy.
4 months on, I’m starting to notice she is behaving a little odd… excessive licking, her foot, just in her mouth, sleeping loads more than she used to, panting, seems hot all the time, and now has bouts of being very restless or disoriented. Getting up and down, walking back and forth and seems almost ‘spooked’ ..
do you know if this is related to the drug?
She is not on any other meds.
I’m concerned. She’s just not herself.
Thank you
Hi Rebecca. It’s hard to know. We are in the first year or two of the use of this treatment so anything is possible. However, I would be surprised if the Beransa is the cause, especially after so long. I’m not sure you will want to stop in to see if the problem goes away, either, so difficult to know how to proceed here.
Hi. Our little Staffy girl is 14, she’s been having Cartrophen injections for many years now and also has Metacam daily. She has had 3 Beransa injections and still has Metacam daily but missed her Cartrophen last round cause the vet suggested to try Beransa. I have found her to be licking constantly, breathing heavily and sleeping way more than usual.
The licking is totally annoying me because she had bad allergies years ago and was on her personally made injections which fixed the problem and cured her allergies, all at a huge $ cost. Now since the Beransa injections she had no allergies but licks constantly, she licks the carpet, the couch, her feet and one night she literally licked the whole kitchen floor! She pants so bad it exhausts her sometimes and she drops down on my lap. Only mentioning this as a few others have also mentioned these symptoms.
Hi Janine. It is indeed interesting that you and another have observed the same thing. Unsure what it might mean.
Hi Andrew,
I have been taking my dog to a vet in [location deleted by Andrew] for 2 yrs. I explained to them that I was going on the road, and could I take 2 dozes of the drug Beransa (which my dog has been on for 4 weeks, with remarkable results). My Vet said yes that would be fine and even got me to inject the last doze so she could see that I was doing it correctly.
I went to pick it up this week, and the Head Vet refused to dispense it to me. I explained the situation, but she just wasn’t interested.
Am I able to get 2 dozes of this amazing drug for my dog as we travel, so she can enjoy the journey with me.
Cheers
Hi Gaylene. This is an interesting question that I myself was wondering about only this week. As usage increases, we will need to develop policies for what to do in these situations. I feel that in our clinic (and most others) we will have to release it for home use at times to avoid dogs missing such an important treatment. This is possibly the first time your vet has faced this question, and I’m sure they’ll eventually have to change their approach, but feel free to reach out to others in the meantime, as you’ll surely get the answer you need. Do be aware that anti-NGF antibodies would be extremely dangerous to a developing foetus, so personally I would ask that both the dog holder and the injection giver are either male or female past child bearing age.
Hi Andrew, I have a 10 year old Shitzu / Maltese x, she has just finished a 4 week course of Cartrophen injections, she is also taking Liquid 4cyte and fish oil with her dinner, her hip is still getting worse, would Beransa help and would I have to stop the other medication. Which is better liquid 4cyte or the little pebbles? Looking forward to your reply.
Hi Ian. Beransa is worth a try if you’re not getting sufficient control, but you’ll only know if it works by trying it. You should be able to continue the other treatments – in our clinic we certainly keep using Cartrophen. As to whether 4cyte is better in liquid or pebbles, I have no opinion.
Hi Andrew,
I have started to notice my dog seems itchier than usual after having around 4-5 Beransa injections. So far we’ve been given a topical allergy treatment however I’m now realising he’s also licking fabric to itch his tongue. Is there a recommended treatment to treat allergies that would pair well with Beransa?
Hi Jessica. I would suggest trying an
Antihistamine – doses are at the link. However, I doubt that the licking of fabric is to itch the tongue – is usually has more of a behavioural cause.
Hi
My 11.5 year old Cattle Dog Gracie had been on Meloxicam, Gabapentin, Paracetemol, Forcyte, Rose Hip Vital and a monthly injection of Cartrophen – which all seem to keep her fairly comfortable (although she still is sore and limps a fair bit by the end of the day and early morning).
So I was really excited to try her on the Beransa injection (but was advised by our vet to cease the Meloxicam whilst she’s on the new injection). She has only had one injection so far and sadly I think there is no improvement at all and she actually seems worse now (which is probably due to the lack of Meloxicam). I am unsure if I should persevere and try her on the second injection due next week or cease it altogether and go back to the Meloxicam?
I have read to at least try it for two months but if it fails then she has to withstand another full month without the Meloxicam which seems to give her more relief. She’s such a lovely and happy old girl and we really want to do what’s best for her. Any suggestions please. Thank you. ☺️
Hi Trish. I can see no reason why you can’t use it together with the meloxicam. The reason for the caution is just that a lot is yet to be known. However, when you look at their modes of action, the two should be unrelated. Of course there’s no guarantee but with these old dogs it’s worth trying everything. Good luck.
Thank you so much for your reply Andrew I really appreciate it. I will ask my local vet again on Monday to please prescribe both medications for her at the same time.
I completely agree with you, that with these older dogs it is definitely worth a try.
Thanks again.
Trish ☺️
My 10 year old border collie had her first injection today. I’m praying years of first not knowing what was wrong with her, to now being diagnosed with arthritis I’m on the right track. Thousands of dollars later. I just want her pain free. Can’t wait. Have been reading these reviews and hope she’s one of the lucky ones.
I have a dog with a partial cruciate tear which we are managing conservatively but her therapists have noticed that the joint is getting arthritic. She is currently having monthly Pentasan shots as well as being on Previcox. Would Beransa be given as well as these?
Hi Robyn. Beransa is really a pure pain reliever, so if your dog has pain, it will help, but it won’t alter the progression of the disease like pentosan might. I might also add – TPLO surgery has been shown to slow the progression of arthritis substantially in these dogs as well as contributing to short-term comfort. Yes it’s expensive at around $4000, but it might prove cheaper in the long run as you probably won’t need the ongoing treatments to the same extent.
I have a 10 y.o overweight labrador. He’s 37.5kg from 45 kg previously. He’s just received his first shot and I was told to wait 6 days to notice full effects and what can I say? He’s like a new little man – running around, no limping. I’m going to do my best to get him monthly shots but fingers crossed I can extend it to every 6 weeks. Excited to see the results so far!
My 4.5 year old lab has had I think three shots. It’s amazing. I have a reminder to take him to the vet each month. I’ve been surprised the last two times as he seems fine. So, I’ve got the vet to remind me after 6 weeks. I’m in perth, wa.
Quick question – are pentosan and beransa given together, or just one needed. Dog is currently on monthly pentosan- vet said he might benefit from beransa, but didn’t say if it was to given instead of the pentosan.
Hi Kim. Pentosan is a disease modifying drug whereas Beransa is pain relieving only, so it’s best to continue both of them.
My 16 year old chihuahua Cheeta had her first injection 5 days ago, and after one day….WOW…. my big old baby is up and around so much more, and she’s more alert. I think she just seems happier. She’s been running and hopping around playing, yes short bursts, but bursts all the same. She is getting up and down from sitting or lying with more ease. And is just appearing out of nowhere like she used to…. last week and many weeks before, she was usually just sitting or lying down and only really moving to get water. We are planning a follow up injection in a month, but so far I’m so happy to see my old girl enjoying the little things in life again, for however long she can. I will mention she’s had to go for her walks in her pram, but let’s see if we need it as much now… which it has a great coffee holder, so I’ll miss that….lol
We tried one shot of Beransa on our 17 and a half-year old Schnoodle. Sadly, we saw little-to-no improvement. She is on Fluox and Gabapentin for pain/anxiety, along with Panadol and has just started on Codeine. Previously, we tried the full course of Arthropen, which gave some relief initially, but then seemed to subside. Our little old girl also has canine-dementia, is blind and deaf – are we prolonging things for her beyond the point of being reasonable? Or would you recommend trying a 2nd shot of Beransa before we say “goodbye”?
Hi Kaley. I always recommend a second shot just to be sure, but in your case I think it’s very unlikely to work and so I don’t think there’s a great need. These are the dogs for which often nothing works very well. I’m guessing there’s a good reason why you’re not using anti-inflammatories, such as liver or kidney problems, but once again, these would probably have minimal benefit. I recently had to make the hard decision with my own 17-year-old dog in a very similar situation, and so it could never be said to be too soon in your case.
Hi, my 12 yr old dog had first shot of Beransa last week. At this consultation they found she had a mass on her Spleen further to a low grade MST. I am going to follow a protocol which I am hoping can aid her as surgery is out of the question. Will Beransa conflict with Benedryl or Cemetidine?
Thankyou
Rebecca
Hi Rebecca. Those two drugs shouldn’t have any interaction with Beransa, but they also won’t have any effect on a splenic mass unfortunately. Have a look at this article on alternative remedies for cancer.
Thanks Andrew! I do follow your comms! I will follow this path as I have spoken to OZ people who have had good results. Not a cure but quality time for both dog and owner. Very much appreciate your response and advice.
R
One of my dogs has had 2 shots and about to have her third. I noticed improvements straight away, like running for no reason just cause she can! I have noticed tho that her breathing a couple of nights was very fast and not normal and she growled 3 times at my other dog which she has never done. My other dog has had 1 injection and about to have her second and her limp stopped! Only side effect is sneezing but not every day . I’m very happy my dogs are running and no limping.
Hi Andrew,
My local vet has told me Beransa does the same thing as Pentosan while also offering month long pain relief. Can you further explain why they would say this?
I have a 16yo Jack Russell who is on his 5th shot of Beransa (never had Pentosan) and he’s loving life more than ever
I haven’t noticed any signs of progression in his arthritis since Beransa, but would love to hear your thoughts!
Hi Jessica. The article does its best to explain how Beransa works. Nobody has a very good explanation for pentosan, although you can find my take on it in our page on dog arthritis treatments.
First pain medication that has shown some discernible improvements in Cruise , he is on Gabapentin, Previcox , 4cyte, Panadol, antinol and tumeric with breakthrough tramadol and codeine, none of which have appeared to have any effect, but would be reluctant to take him off just in case.
It is so good to see his improvement . Looking forward to his 2 nd injection ! Thank you
Hi our 13 yr old Golden retriever is on her third injection of beransa. We had a scare at the end of 2nd injection as she was drinking copious amounts of water (always has been a good water drinker) but this was crazy and she definitely wasn’t happy panting, slightly more incontinent and very flat, so obviously in pain! Took her to vet following morning they did thorough inspection and ultrasound all good, but put her straight on antibiotics, 24 hrs later a new dog! So we decided to give her a 3rd injection of beransa as wasn’t sure if that had been the issue ? Now one week into it and same thing starting to happen, she’s happy enough but the excessive drinking and noticing a bit of incontinence again , seems like beransa might be the trigger? Have you hear anything similar?
Hi Donna. No I haven’t, and it’s odd that antibiotics seemed to cure it (have a look at the causes of an excessive thirst here and you’ll see why). Please let me know how she goes and if you get an answer.
Great thanks so much.
Yes, rather complex indeed!
From the literature, and calling my vet this morning at least 2/3 injections to see if there is any benefit.
Possibly more so for the fully able limbs and body that still has feeling!
Your time and knowledge is much appreciated Dr Andrew. Thank you.
Hi Dr Andrew,
Our local vet here in WA has recommended Beransa as a trial to manage symptoms for our 4yo GSD who suffered brachial plexus avulsion at 2.5yo.
Is there a minimum trial period you would recommend for any outcomes? He has had one injection only at end April without any noticeable changes so far, however l do think that given each being absorbs meds differently, that it is far too early to make a call of whether to continue or not after one injection.
Reading the literature, it looks too soon to abort the trial.
Our GSD is approx 45kg. He is also a very happy dog so seeing any pain in him could well be masked by his zest for life no matter what challenges he has faced, which is a heck of alot of trauma so far.
Thanks for any feedback.
Hi Julie. I’m guessing there is more to this case than presented here, as brachial plexus avulsion itself is not normally painful, instead being a loss of neurological function. As to whether Beransa can be used in off label situations like these, there will no doubt be more uses than the narrowly defined registered use for osteoarthritis, but we can’t say much yet. Personally if I was trialling it, I would expect to see a response with the first injection, but would do a second one to just to be sure before giving up.
We have a 28 kg 13 year old Labradoodle who is deaf and partially blind , he relies on his sense of smell, his rear right leg predominantly is bad with osteoporosis/arthritis and he has had his first dose of Beransa today 7th July 2023 , the majority of reviews are very positive. We only heard of this treatment yesterday so we moved hastily as RUMPOLE being the age he is we believe he needed to have a better life. Rodney Hardy
Hi Dr Andrew,
Thank you for writing this article. I am currently researching and considering trying Beransa on a 11.5 yr old Kelpie with multiple health issues including epilepsy (currently controlled). Why is Beransa recommended above Zydax?
Hi Wendy. If you look up the mechanisms of action for each, you’ll see they are very different. Generally speaking, we would expect Beransa to be significantly more effective.
Our 11.5 yr old Rottweiler is due for her second injection tomorrow and it’s done wonders for her. She’s walking more and not struggling to get up. Only change noted, she has been drinking a lot more water but overall it has been very positive and making her more comfortable in her old age. Let’s just hope the price comes down, making it more affordable for everyone that needs it.
We are in Australia and our 13.5 year old lab staff x who has a crippled leg and suffers from grade 4/5 arthritis has had his first injection 3 weeks ago and is soon due for his second injection. We noted after a couple of days a big improvement! We have taken him off 0.5 Carprofen and he is still not limping more but he is still on his Gabapentin. We are so far very excited about the results!
My Kelpie has just received his first injection , hoping with all my heart that this works for him. We are in Australia and has just been released here, will update ❤️
Hi Tricia. Please do!
Hi Andrew, he has now had his 3rd injection and amazing results, no limping and walking a little bit longer ( my choice at the moment ) but he is doing really well ❤️
Love the article.
My dog (9 years old cocker spaniel), had IMHA last year, which is controlled now.
A few months ago, after playing on the beach, he couldn’t standing up and after that every time he plays or walk a little more, he can’t standing. We’ve done a CT scan to check his back and found a bulge disk and a tumour on his spleen – which was removed a couple of months ago.
The vets are 100% sure his problem is arthritis on his ribs and not his back – apart from the CT we’ve done clinical tests and RXs. They recommended Beransa, but one of the vets is concerned that it may trigger his IMHA.
Any thoughts or studies about triggering the immune system? Thank you
Hi Vanessa. I can’t see any reason to think that this treatment would be more likely to cause autoimmune problems than any other.
Hi, my dog has had 2 Beransa injections. Is there anything in the literature about gut inflammation being a possible side effect?
Hi Jo. No there isn’t, but if you’re noticing a link it’s worth stopping and possibly even restarting again to see if it coincides. The only way we are going to find out if these things happen is to investigate and then report the results to the APVMA or FDA.
Hi
Is the treatment safe for a dog with cushings
Hi Jane. There’s no reason to think that it won’t be safe.
Hi Jo, My boy also has an inflamed gut after his second injection, and just seemed very dull and almost depressed. I have not given him a third injection, and he seems to be doing better. How is your dog doing?
Hi Karen, my boy also seemed dull and depressed after his 3rd injection. And he has been very quiet. A week after we also had an episode of unusual foamy vomit and he’s not been himself since. We had a good response after the first 2 injections though…not sure if it’s related or not.
Great article; thank you. With a young dog (18m) with arthritis, this seems like a good alternative to other injections available.
You do realise it’s just pain relief though and without other treatments your dog will get worse?
Thanks Jason. You’re probably right, but at the same time it will be very interesting to look back on this treatment in 10 years and see if it did alter the progression of the disease at all. Currently, very few things do this.
Our 45kg German Shepard has just had his second injection today, but within days of his first injection he was getting around so much better. Had tried other injections but none have shown such a big improvment as what Beransa has.
Hi Leanne, how long did your shephard recieve relief from the 1st dose?
Where near Pittsburgh PA can you get this drug?
Hi Karen. It should be available at your local vet under the brand name Librela.
Looks good but what does it actually do? I think it’s just pain relief or does it actually help fix arthritis?
Hi Jason. If you have a look at some x-rays of osteoarthritis (on this page, for example) you will see that it’s not really possible to fix arthritis. So you are right, it is more about managing the symptoms to the dog.
Yeah that’s my point. I just got concerned that all these people are stopping other treatments which help, and are relying on this one which is just pain relief. Thanks Andrew 🙂
I tried Beransa with my near 14 year old cattle dog. He was on Zydax for a couple of years which was very good but after just one injection it was like he was years younger! My vet recommended it & suggested we try it. Well, all I can say is WOW. He is much happier, doesn’t struggle so much anymore getting up & doesn’t pant so much from pain when going for a walk. He also loves his squeaky toy game again, It’s not a silver bullet, but it is a great relief to see my old man enjoying himself again. I would seriously recommend it .It’s a new lease on life .As far as cost goes, well, how much is your best buddy’s health & happiness worth? For me you can’t put a $$ value on that.
I have a Boxer, and for the past 10 months, his back legs have been rapidly deteriorating, to the point where he has barely been able to walk back from the park for the past 6 months or so, so I got him a doggy pram, and have been driving him also. He is on Amantadine, Meloxicam, Gabapentin, Paracetamol as required, and Green Lipped Mussel. None of these seemed to have helped, and it’s been awful watching him struggle. He had his first injection of Beransa about 3 and a half weeks ago, and the difference in him is INCREDIBLE!!! I cried happy tears today, because I tried it for him, even though I’m very sceptical as nothing else has seemed to work. It’s like it has taken years off of his back legs! It is a genuine joy again to take him to the park, and to be able to walk with him and let him run around and not have to stop him from having fun, for fear he may be “overdoing it”, and barely be able to walk afterwards. I will NOT advocate for anything that I haven’t had my own personal experience with, and honestly, the improvement in him blew me away. It’s definitely not cheap, but seeing as we can now cease 4 other medications, this will be much better for his liver and kidneys, and with the drastic improvement in his quality of life and pain relief, it is definitely worth it for me. Sorry for the long story, I’m simply passionate about my dog’s quality of life, and excited that there is hope yet 🙂
Hi Annie. Thank you so much for telling us your experiences – it’s such a new treatment that this improves our confidence in recommending it to others.
Thanks Annie, that’s good to know. Glad you got a good result 🙂
That s lovely news. My Labradore has just had his 2nd shot hoping for the same results as the first one had .We would try anything to keep him healthy. He will be 11 years in October .Try this it does work .God Bless.
Thank you for this article. I heard there was a new arthritis treatment for dogs and wondered about its efficacy given we now have 3 dogs with arthritis.