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Nonsteroidal Anti-Inflammatory
Drugs (NSAIDs) are the most widely used medications in veterinary
medicine commonly prescribed for pets with various painful
and inflammatory conditions, including arthritis and post-surgical
pain relief. The most common adverse effects are stomach ulcers,
kidney, liver, and blood disorders. When treating chronic
pain associated with arthritis, the effectiveness of NSAIDs
can be improved by physical therapy, use of joint protective
drugs, and diet and exercise to control weight.
There are a number of non-steroidal anti-inflammatory drugs
(NSAIDs) approved for use in dogs including:
Rimadyl
(active ingredient carprofen) and
EctoGesic (active ingredient etodolac).
Feldene (common ingredient piroxicam) is often prescribed
for use in dogs with cancer for pain control. There are currently
no approved NSAID products for cats in the United States and
any NSAID use in cats must be done carefully under a doctor's
supervision. Since control of pain and inflammation in pets
with arthritis is likely to require some type of chronic therapy,
it is important to know the side effects in arthritic pets
treated chronically ( greater than one year) with non-steroidal
medications.
Although Rymadil and EctoGestic have only recently become
available, there are some statistics. In 1998 Rimadyl led
the list of drugs reported to cause adverse reaction in dogs(43.4%
of all adverse drug reactions were due to Rimadyl). This is
due to any number of causes: older pets who are often dehydrated,
pets taking multiple medications such as heart medications
that could increase toxicity of NSAIDs like Rimadyl, have
organ disease or failure, and are not regularly screened for
underlying problems and side effects. While NSAIDs can be
safely used for short-term pain relief in most pets, other,
safer options are preferred for long-term relief in arthritic
pets, for whom Rimadyl is most often prescribed.
Side Effects of Rimadyl,
EctoGesic, or any NSAID:
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Gastrointestinal System - bleeding, ulceration, perforation, inflammation of the pancreas,
diarrhea.
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Kidney
- kidney failure. Older pets are at greater risk. Any time dehydration is present, the risk of kidney disease increases. Pre-treatment blood and urine testing can detect some but not all kidney problems.
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Liver
- elevated liver enzymes, liver failure. The most serious side effect seen in dogs taking Rimadyl was liver disease. Labrador Retrievers seem to have predisposition to develop more serious side affects leading to liver failure than other dog breeds.
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Immune System - anemia, skin reactions.
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Neurologic System - Seizures, paralysis, unsteadiness
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Miscellaneous - Aggression, depression, hyperactivity.
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Musculoskeletal System - cartilage damage. Both Rimadyl and EctoGesic appear to cause less cartilage destruction than other NSAIDs, although the safety margin in these products is very narrow: elevated dose level of EctoGesic at 2.7 times the maximum daily dose causes gastrointestinal ulcers, vomiting, and fecal blood and weight loss.
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Drug Interaction - NSAIDs like Rimadyl and EctoGesic can interact with other medications which can result in increased or decreased concentration of the medications in the pet's blood. Drug interaction most likely occurs in pets taking medications for epilepsy, such as phenolbarbital, or for heart failure, such as Lasix (furosemide), digoxin, and
Enacard.
To treat post-surgical
pain, NSAIDs are more effective when used together with other
pain relief medications, and in well-hydrated pets with normal
blood pressure and kidney function. For pets with arthritis,
owners can try therapies to reduce pain and inflammation including
omega-3 fatty acids, acupuncture, antioxidants, magnetic beds,
and herbs. Glucosamine and chondroitin sulfate supplements
can also nourish and repair the cartilage.
Although in many pets NSAIDs can be used safely for post-surgical
pain relief for a short period of time (3 to 5 days), it is
important to carefully follow the prescribed dosages.
Accidental Exposure of Pets to NSAIDs
- In January, 2005, The ASPCA Animal Poison Control Center
alerted pet owners to the dangers of NSAIDs used for humans,
such as aspirin, ibuprofen, naproxen
and ketoprofen.
While these medications can be beneficial to humans, they
can potentially be very hazardous or even deadly to pets,"
warns Dr. Steve Hansen, veterinary toxicologist and Senior
Vice-President of the ASPCA Animal Poison Control Center.
Pets can be accidentally exposured to NSAIDs by chewing into
a medication bottle or ingesting pills left unattended, or
as a result of pet owners inappropriately medicating their
pets without the direction of a veterinarian. "Pet owners
should never give their animal any medication without first
talking with their pet's veterinarian," Dr. Hansen advises.
Pet owners should store medications in a secure cabinet well
out of the reach of animals, as even child-proof containers
can be easily chewed open.
As with any substance, if you suspect your pet may have become
exposed to an NSAID, contact your local veterinarian or the
ASPCA Animal Poison Control Center (1-888-426-4435) for immediate
assistance.
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