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Care & Husbandry: A Vet's Guide to Pain Reliever Use for Dogs

Your beloved dog is showing signs of discomfort after a romp in the backyard. As you scan your medicine cabinet for possible remedies, you spot aspirin, ibuprofen, naproxen, acetaminophen, and even some RIMADYL tablets from a previous prescription. But before you reach for any of these, halt right there and dial your veterinarian. Not all pain relievers are created equal, and what's safe for you or another pet might not be suitable for your dog.

Understanding NSAIDs: The Pain Relief Powerhouses

Except for acetaminophen, the medications in your cabinet fall under the category of nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are go-to solutions for managing pain, inflammation, and fever in both humans and animals. Veterinarians frequently prescribe NSAIDs for dogs dealing with osteoarthritis or recovering from surgery.

The Science Behind NSAIDs

NSAIDs operate by influencing prostaglandins, substances released by the body in response to injury or irritation. When cells are damaged, the enzyme cyclooxygenase (COX) kicks into action, leading to the production of prostaglandins. These substances contribute to pain, inflammation, fever, and play protective roles in the stomach, intestines, kidneys, and blood clotting.

Many NSAIDs either block COX or impede the activity of specific prostaglandins, reducing pain and inflammation. However, this interference can bring about side effects, some of which can be severe.

Common Side Effects of NSAIDs in Animals

The most frequently reported side effects of NSAIDs in animals include:

  • Vomiting
  • Decreased or loss of appetite
  • Reduced activity levels
  • Diarrhea

In more severe cases, NSAIDs can lead to stomach and intestinal ulcers, perforations, kidney failure, liver failure, and, in rare instances, death.

Understanding Side Effects: Digestive Tract, Kidneys, and Liver

Digestive Tract (Stomach and Intestines): NSAIDs can irritate the stomach lining directly due to their physical properties. They also indirectly impact the digestive tract by inhibiting prostaglandin production, reducing its protective effects. This can result in ulcers and perforations.

  • Kidneys: NSAIDs may decrease blood flow to the kidneys, potentially causing kidney damage and sudden-onset kidney failure, especially in dehydrated animals or those with kidney disease.
  • Liver: NSAID-induced liver damage can be dose-dependent or dose-independent. An overdose can lead to severe liver damage, while dose-independent toxicity is an unpredictable reaction, often occurring within the first three weeks of medication.

Blood Tests for Monitoring: Regular blood tests are recommended for dogs on long-term NSAID therapy to assess liver and kidney function.

FDA-Approved NSAIDs for Pets

Several NSAIDs are FDA-approved for dogs, including:

  • Carprofen (Marketed under multiple trade names)
  • Deracoxib (DERAMAXX, DOXIDYL)
  • Firocoxib (PREVICOX)
  • Grapiprant (GALLIPRANT)
  • Meloxicam (Marketed under multiple trade names)
  • Robenacoxib (ONSIOR, for a maximum of 3 days)

For cats, only meloxicam and robenacoxib (ONSIOR) are FDA-approved, with meloxicam used as a one-time injection before surgery.

Benefits and Risks of FDA-Approved NSAIDs

While FDA-approved NSAIDs offer effective pain relief, there are associated risks, especially considering reported side effects in older dogs with additional health issues. To reduce risks, careful monitoring and adherence to veterinarian recommendations are crucial.

Over-the-Counter Pain Relievers: A Risky Choice

  • For Dogs: While humans often resort to over-the-counter pain relievers like aspirin, ibuprofen, or naproxen, these can have adverse effects on dogs due to differences in absorption rates and metabolic processes.
  • For Cats: Cats are even more sensitive, lacking the ability to break down NSAIDs efficiently, making accidental ingestion extremely dangerous.

Common Over-the-Counter Pain Relievers for People:

  • Aspirin (ASCRIPTIN, BAYER, BUFFERIN, ECOTRIN)
  • Ibuprofen (ADVIL, MOTRIN)
  • Naproxen sodium (ALEVE, MIDOL EXTENDED RELIEF, NAPROSYN)
  • Acetaminophen (TYLENOL) - Not an NSAID, but important to note.

Acetaminophen Toxicity in Pets

  • Dose-dependent liver toxicity
  • Red blood cell damage, especially in cats

Acetaminophen is fatal to cats and should never be given to them.

Guidelines for Pet Owners

  • Consult your vet before giving any NSAID to your pet.
  • Inform your vet of any digestive issues or ongoing medications.
  • Monitor your pet for side effects during and after NSAID therapy.
  • Report any side effects promptly to your veterinarian.
  • For long-term NSAID use, consider baseline blood tests for your dog.

Before reaching for a remedy, remember: Your dog’s health is paramount. Always consult your veterinarian for the best and safest course of action.

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