The Problem With NSAIDs For Dogs

Dog sniffing NSAIDs

The names of Rimadyl, Metacam, Deramaxx, and Previcox are likely ones you have heard. 

These Non Steroidal Anti-Inflammatory Drugs (NSAIDs) are often prescribed by veterinarians.

They help reduce inflammation and pain in a disease like arthritis. They are also used for many other minor injuries and diseases involving inflammation.

At some point during your dog’s life, your vet may recommend NSAIDs. But the vet may not tell you about the risks associated with these drugs

..this is the information you need to make an educated decision about your dog’s care.

How Do NSAIDs Work?

NSAIDs inhibit the production of prostaglandins.1

Prostaglandins produced from fatty acids come from all cells in the body. The different types of prostaglandins in the body work to control inflammation. 

When tissue damage occurs, an enzyme system converts arachidonic acid to prostaglandins. This conversion is cyclooxygenase and there are two types: cox 1 and cox 2.2

NSAIDs can inhibit cox 1, cox 2 or both.

Cox 1 functions include:

  • promote blood vessel constriction and platelet clotting when needed
  • control stomach acid production
  • promote gastrointestinal mucus secretion to protect the gut lining
  • increase blood flow to the kidneys

Cox 2 functions include:

  • activating an inflammatory response with pain and fever
  • inhibiting blood vessel constriction and platelet clotting when clotting is not needed

Manufacturers try to produce NSAIDs that inhibit cox 2 more than cox 1. Carprofen (the active ingredient in Rimadyl) demonstrated this in vitro (not in a live animal).1

Aspirin inhibits both. This is why aspirin can thin the blood and can cause stomach ulcers. This might be okay if you’re trying to prevent blood clots and stroke. 

This isn’t okay if your dog needs to build a clot after a procedure. An example would be their inability to form a clot after a tooth extraction if taking aspirin. 

What The Experts Say About NSAIDs

Dr. Colin Burrows is an internal medicine specialist at the University of Florida College of Veterinary Medicine. 

He states, “Aspirin and other NSAIDs frequently cause gastritis or peptic ulcers and should be avoided unless absolutely necessary”.

NSAIDs designated for human use, such as ibuprofen … are not safe for use in dogs or cats. 

These drugs cause severe, fatal gastric and intestinal ulceration.” 3

The manufacturers of Metacam report the following warnings,

“As a class, cyclooxygenase inhibitory NSAIDs may be associated with gastrointestinal (gut), renal (kidney), hepatic (liver) toxicity… 

dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID.

Serious adverse reactions associated with this drug class can occur without warning and in rare situations result in death.” 4

Kidney specialist Dr. Gregory F Grauer has a warning for dog owners. 

“dogs of advanced age, those with subclinical kidney disease, or on concurrent medications such as furosemide…

 …are at an increased risk for kidney damage when an NSAID is added to their treatment protocol”

Idiosyncratic reactions (meaning the cause is unknown) can occur with any NSAID use. Some dogs may be more prone to reaction due to genetic predisposition.

Reports of liver disease from carprofen (metabolized by the liver) use is only 0.05% of dogs treated. ….but not all reactions are always reported.

Regardless of the percentages, a reaction doesn’t feel so rare when it affects your pet!

I’ve seen a distraught pet owner who learned her dog had irreversible dry eye. After a course of the NSAID etodolac (Etogesic). 

And the anger of a pet owner whose pet suffers from kidney disease caused by deracoxib (Deramaxx).

And even worse,  most dog owners are not forewarned of these dire side effects.

Negative Side Effects of NSAIDs

If your dog is taking NSAIDs, you need to watch out for reactions. Common NSAID reactions include:

*vomiting with or without blood

 * black stool or blood in the stool

* loss of appetite

*lethargy.

Routine blood work is key as the MAJOR side effect is anemia or low protein in the blood. Due to blood loss in the gastrointestinal tract. 

What are the Benefits And Risks of NSAIDs

Drs Roach and  Johnson from the CVM at the University of Georgia are in agreeance. They state that NSAIDs have a place in the management of osteoarthritis in dogs.

They also recommend adding in joint support as added protection. 

Things like polysulfated glycosaminoglycans, oral glucosamine, chondroitin sulphate, hyaluronan, and even acupuncture.

They may also prescribe opioids … such as butorphanol or Tramadol for pain.

They emphasize nutrition and low-impact exercise (such as swimming) for weight control. Disease will progress despite these therapies, they say.5

So why do they recommend all these other therapies? NSAIDs are not effective in improving the health of a joint and some may even add to joint damage. 

By adding in alternative therapies we can support the joint better.

Two studies looked at Metacam (Meloxicam) use in dogs.  277 dogs demonstrated subjective improvement in all symptoms in the first.  Only two parameters improved in the second study.

Related: Why this vet says NO to Gabapentin …

Can NSAIDs Make Arthritis Worse?

According to Dr. Ross Hauser, “One of the most serious adverse reactions to NSAIDs, that is little appreciated, is that as a class of compounds they cause the breakdown of articular cartilage…” 

“…thereby accelerating osteoarthritis, the very disease for which they are most commonly prescribed! The pathogenesis of osteoarthritis is accelerated by NSAIDs.” 6

Even the authors of the esteemed Small Animal Surgery textbook state caution. 

“Most NSAIDs interfere with chondrocyte (cartilage cells) glycosaminoglycan synthesis and therefore should be used continuously only for a short time.”

They suggest adding in stomach protection to the list of added support when using NSAIDs. 7

It’s hard not to conclude that the risks outweigh the benefits of NSAIDs for dogs. 

Why reach for them when there are natural options that can be as effective?

Related: Supplements To Help Your Dog’s Arthritis Pain …

The Body’s Natural Ability To Heal

“… the sensation of pain is a deeply ingrained trigger within the body to quickly protect it from harm.” – Jodie Gruenstern DVM

Sometimes we forget how good the body is at doing what it’s meant to do. The best approach to medicine is often not to interfere with the body’s natural processes.

The concept of hormesis embraces this fact. It teaches us that a little stress is something that helps the body to repair and strengthen.

Inflammation is a natural, protective, physiologic mechanism. It is necessary to stimulate the body’s healing processes.

Inflammation comes from the Latin word meaning “fire”. This is fitting if you have ever experience red and warm pain of inflammation. 

The initial pain of inflammation forces us to stop the insult to the tissue. This then allows the healing process to begin. 

If you touch a hot stove, the burn will only begin to heal once you remove your hand from the stove. If you touched the stove and didn’t feel any pain, your hand would suffer considerable burning and damage. 

Chronic inflammation is difficult to manage. It’s more than removing your hand from the hot stove. Inflammation becomes chronic when it has been active for a period of time without relief. 

For example, a sliver, or an intestinal foreign body will stimulate inflammatory cells. Their mission is to attempt to expel the invader until it’s removed.

So, pain and inflammation would seem like a good thing for the body. Yet conventional medicine says we should suppress inflammation … I guess because it hurts?

The good news is there are other options.

Natural Alternatives To NSAIDs for dogs

There are several natural treatment alternatives to NSAIDs. That relieve discomfort in dogs without the side effects of NSAIDs.

Zeel

A study looked at the use of the homeopathic blend Zeel® (made by Heel). Dogs with moderate to severe osteoarthritis used it for 8 weeks. 

This group had much less pain than their placebo peers. Although carprofen was more effective.

Homeopathy as a treatment is often seen as elusive and controversial. The thing is though that they are safer than NSAIDs. 

Further investigation into the Zeel remedies show that two remedies can inhibit leucocyte elastase. An inflammatory enzyme that can damage articular cartilage. 

Arnica montana inhibited this enzyme activity by up to 70%.  And Rhus toxicodendron inhibited the leucocyte elastase up to 77%.

Less cartilage damage means less pain for your dog.8

These findings help scientists understand and accept the validity of homeopathic medicines. 

The more mainstream our natural treatments become, the more our animals will benefit.

Traumeel

From the same parent company Heel, comes Traumeel®. Made popular among humans who find it to be effective.

 Many holistic veterinary practitioners and rehab specialists use this blend.

Zeel is best for osteoarthritic conditions while Traumeel is great soft tissue injuries. Each comes in tablet or injectable form.

*Note: Heel has exited the US and Canadian markets and Heel Inc.  sold to MediNatura Inc. You can now look for T-Relief Arthritis and T-Relief*

 Protection and pain relief with Corydalis for dogs

This Chinese herb is a natural anti-inflammatory and can replace many NSAID prescriptions. Corydalis is an analgesic that actually protects the GI tract.

Patients with chronic inflammation, stomach, and intestinal ulcers, had a 76% improvement in symptoms!

Corydalis contains THP (tetrahydropalmatine). They found it reduced nerve pain in 78% of human patients tested in a 1990 study.

 Sedation and anticonvulsant effects are other indications for this herb.

The species used is Corydalis yanhusuo.  It is a native to the northern Chinese province of Zhejiang.

Dogs find calming pain relief with California Poppy

If mild sedation is also needed for a painful pet, California poppy comes to the rescue!

Clients who skipped NSAID use after surgery found California poppy provided pain relief.  Studies show it contains small amounts of morphine and has analgesic effects. 

The Benefits of Boswellia for dogs

Boswellia is also an effective anti-inflammatory and is often used by migraine sufferers. 

Pet owners report stopping or lowering NSAID use for osteoarthritis when using boswellia. 

A clinical trial looked at the effectiveness of Boswellia serrata. 

71% of dogs with degenerative conditions showed improvement. 

This is likely due to the presence of boswellic acids in the herb. These acids can reduce inflammatory cell infiltrates.9

Quality and efficacy can vary among herbs and other natural supplements. This is why I recommend Standard Process Boswellia.

Consider Arnica for pain in dogs

My experience with Arnica is with the herbal liniment from Buck Mountain Botanicals. This provided amazing relief for a Labrador retriever with severe neurologic pain.

NSAIDs, Tramadol and gabapentin did nothing…. but this old-fashioned topical brought immediate and long-lasting relief.

Homeopathic preparations of Arnica are safe. . . but oral Arnica the herb on its own is toxic. So you will need to watch out for licking!

Some active components in Arnica are the sesquiterpene lactones. A chemical class of constituents present in many herbals and essential oils.

Related: Green lipped mussel and joint pain …

Essential oils: Copaiba, Wintergreen and Peppermint 

Don’t underestimate the hot/cold relief you can give your dog with these essential oils. 

 Massage these diluted oils onto the affected area. Save one drop of peppermint for last … 

Peppermint is a potent oil that drives the others in deeper.

Copaiba is high in beta-caryophyllene, a potent anti-inflammatory. It’s a resin tapped from a Brazilian tree and not distilled. 

Copaiba is generally regarded as safe for use orally or topically for arthritis.

Wintergreen contains methyl salicylate which is an anti-inflammatory and analgesic. It is good for conditions such as arthritis, muscle, and nerve pain.10

I use all three of these oils topically for almost all my canine patients. May of which have spondylosis, disc disease or osteoarthritis.

You may recognize salicylate or salicylic acid as the chemical constituent in aspirin. 

The chemical balance in herbs and most essential oils is why fewer side effects are often seen. In comparison to the drug counterpart.

Related:The Dangers Of Undiluted Essential Oils For Your Dog …

Why are natural alternatives better than NSAIDs?

Natural products offer a safe and effective approach to controlling chronic inflammatory disorders. History has shown this.

Most medical discoveries began with studying historical uses of plants as traditional remedies.

When plant chemicals are in isolation they begin to get more dangerous.

Greg Tilford is a notable herbalist. He once told me, “Don’t ever forget, the whole herb is always greater than the sum of its parts.”

This is especially true when we’re discussing safety.

Natural remedies help the body’s innate ability to change or balance itself. 

Drugs tend to force the body into change.

Many natural approaches can be given together. They work well in conjunction with laser therapy, massage or acupuncture. 

While some would be best alternated, especially energy medicines. Check with your holistic vet to be sure.

All these natural options for pain and inflammation merit further investigation. 

Studies and massive amounts of anecdotal evidence are supportive of natural solutions.

Pet owners have the right to know natural alternatives. This is how you can make an educated health plan for your dog. 

References
  1. Plumb’s Veterinary Drug Handbook Plumb 2008
  2. Virtual Chembook Elmhurst College Ophardt 2003
  3. Clinical Medicine of the Dog and Cat Iowa State Press Schaer 2003
  4. Metacam insert, Boehringer Ingelheim Vetmedica, Inc.7/2010
  5. Clinical Veterinary Advisor Second Edition Cote 2011
  6. Journal of Prolotherapy Volume 2 Issue 1 February 2010
  7. Small Animal Surgery Mosby Fossum 1997 p.945
  8. Evidence-based Complementary and Alternative Medicine 2009 December (6) 4, 465-471
  9. Veterinary Herbal Medicine Wynn and Fougere 2007
  10. Essential Oils Desk Reference Fourth Edition 2009

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