Arthritis is one of the most common conditions in older dogs, affecting an estimated 80% of dogs over 8 years old. For decades, Metacam (meloxicam) has been the standard treatment. Since 2021, Librela (bedinvetmab) has offered a completely different approach. Here is how they compare for UK dog owners.

How They Work

Metacam is a non-steroidal anti-inflammatory drug (NSAID) given as a daily oral liquid. It reduces inflammation and pain by inhibiting COX enzymes. It has been used in veterinary medicine for over 20 years.

Librela is a monoclonal antibody injection given once a month by your vet. It targets nerve growth factor (NGF), a key protein involved in osteoarthritis pain signalling. It was the first monoclonal antibody licensed for pain in dogs.

Cost Comparison

  • Metacam oral suspension: £15–£40 per month depending on dog size and where you buy. A 100ml bottle for a medium dog lasts roughly 4–6 weeks and costs £18–£30 from an online pharmacy.
  • Librela injection: £60–£95 per monthly injection at your vet, depending on the dog's weight bracket.

Librela is substantially more expensive — roughly 2 to 4 times the cost of Metacam. Over a year, that is the difference between £180–£480 for Metacam and £720–£1,140 for Librela.

Effectiveness

Both treatments provide significant pain relief for most dogs with osteoarthritis:

  • Metacam: Well-established efficacy. Most dogs show improvement within 3–5 days. Works well for mild to moderate arthritis.
  • Librela: Clinical trials showed around 75% of dogs responded positively within the first month. Some owners report dramatic improvements in mobility and quality of life, particularly in dogs with severe arthritis.

Librela can be particularly beneficial for dogs who cannot tolerate NSAIDs (for example, those with kidney disease) or dogs where Metacam alone does not provide sufficient pain relief.

Side Effects and Safety

Metacam: Long-term NSAID use can affect the kidneys, liver, and gastrointestinal tract. Dogs on Metacam should have blood tests every 6–12 months to monitor organ function. It should not be used in dogs with existing kidney or liver disease.

Librela: Generally well tolerated. The most commonly reported side effects include injection-site reactions and urinary tract infections. Because it does not go through the kidneys or liver in the same way, it can be used in dogs with organ disease. However, post-market surveillance has reported neurological side effects in a small number of cases, and the VMD continues to monitor safety data.

Can They Be Combined

Yes. Some vets prescribe Librela alongside a reduced dose of Metacam for dogs with severe arthritis that does not respond adequately to either treatment alone. This is known as multimodal pain management and is considered good practice for difficult cases.

Which to Choose

Metacam is the more affordable option and works well for most dogs. Start here unless your vet has a reason not to. Librela is worth considering if your dog cannot take NSAIDs, has not responded well to Metacam, or has severe arthritis significantly affecting quality of life. The higher cost may be justified by the improvement in your dog's mobility and comfort.

Last updated: March 2026. Prices based on UK veterinary data. Always consult your vet before changing arthritis treatment.