NSAIDs – What you need to know!

Dr. Melissa Schupp

Your best pal Lassie comes in from playing outside and you notice she is limping on one of her back legs.  You begin browsing through your medicine cabinet looking for some medication that may relieve her pain.  You see some aspirin, naproxen, ibuprofen and acetaminophen.  You also see an old bottle of carprofen left over from when your other dog had knee surgery.  Naproxen always makes your headache go away quickly so, why not give some to Lassie?  STOP!  Call your veterinarian before you give anything!  Medications meant for you or for another dog may not be right for Lassie and could even hurt her.

With the exception of acetaminophen, the drugs listed above are all nonsteroidal anti-inflammatories (NSAIDS).  These medications are used frequently in both people and pets for their pain-relieving, anti-inflammatory and anti-fever effects.   They are often prescribed for animals for arthritis or post-surgical pain.

So what do NSAIDS actually do?  Bear with me while we go through a bit of science.  NSAIDS block an enzyme in the body called cyclooxygenase (COX).  COX stimulates damaged cells to produce substances called prostaglandins which have several functions:

-Protect the stomach lining from the damaging effects of acid

-Helps maintain blood flow to the kidneys

-Supports platelet function

-Contributes to pain, inflammation and fever

When COX is blocked by NSAIDS, pain, inflammation and fever are reduced which is great, but there can also be side effects.  Some of the common side effects seen with NSAID use are vomiting, decreased or absent appetite, decreased activity and diarrhea.  More severe side effects can include stomach and intestinal ulcers, stomach and intestinal perforations (holes in the wall of these organs), kidney failure, liver failure and even death.

The Food and Drug Administration (FDA) has approved many NSAIDS for use in dogs (carprofen, meloxicam, deracoxib, firocoxib, etodolac and robenacoxib); only two are approved for use in cats (meloxicam and robenacoxib).  This means that those medications have been shown to be safe and effective for use in that species.  NSAIDS that are approved for human use do not have the same effectiveness and particularly the same safety margin if given to your pet.

Dogs and cats are not small people!  People, dogs and cats are different species and will absorb, metabolize and react differently to medications.  A medication used for a human may last longer, have a higher absorption rate in the stomach and reach much higher concentrations in the blood stream when given to a dog.  Cats lack an enzyme allowing them to break down NSAIDS making them particularly sensitive.

Let’s look at an example.  Naproxen is a very safe and effective NSAID used in humans.  But just a single dose when given to a dog can cause severe gastrointestinal upset, stomach ulcers, intestinal perforation and kidney failure.  Effective treatment can require many days or even weeks in the hospital and cost thousands of dollars.

So, what should you do?

First, never give any medication to your pet without discussing it with your veterinarian first.  We are too often faced with a well-meaning pet owner who unintentionally caused their pet harm by giving a medication.  It is one of the most devastating problems we face.

Next, always inform your vet of any medications your pet is on – prescribed or not.  Two different NSAIDS or an NSAID and a steroid should never be given at the same time.

Ask your veterinarian about performing baseline blood work prior to starting any long-term NSAID therapy.

Never change the amount or frequency you administer to your pet without first talking to your veterinarian.

Finally, if your pet is on a prescribed NSAID, monitor him for side effects and inform your veterinarian if you see them.

NSAIDS are a very valuable and important part of medical treatment for our pets and for us.  But we must take care to use them safely!  This is not only true for NSAIDS but any medication we choose to give.  Before you reach into the medicine cabinet for a medication for Lassie, please call your veterinarian.  We are here to help you keep your pet healthy and happy for a long, long time!