Are NSAIDs really worth as a pain management option for your dog?
So you suddenly notice your dog (Yuri) has developed a limp in one of his legs and is having difficulty walking or sitting (Signs and symptoms of pain in dogs). You have some pain medication lying around which was previously prescribed to your other elderly dog (Molly) for her osteoarthritic knee. To provide some instant relief to Yuri, you decide to give him Molly’s medicine.
Don’t ever do that…!!
You might do more harm than good…
As per FDA, there is only one over the counter drug, you can use in emergencies (with prior discussion with your vet of course). It is acetaminophen (commonly known as Tylenol/Paracetamol).
Effect of NSAIDs on dogs
However, one precaution to be kept in mind is that acetaminophen is not harmful to dogs but is FATAL TO CATS. Cats lack certain liver enzymes which are needed for proper breakdown of acetaminophen. In some cases, acetaminophen can also cause liver damage and reduce the oxygen-carrying capacity of blood (this is where the prior discussion with your vet comes in handy. He/she can best tell you the dose and if your pup might be allergic to the same).
Now, let’s discuss the most commonly administered drug to canines in case of pain: the non-steroidal anti-inflammatory drugs (NSAIDS).
What are Non-steroidal anti-inflammatory drugs?
These are drugs which are used as pain relievers in case of both canines and humans. These drugs have antipyretic (anti-fever), anti-inflammatory and pain-relieving properties. These drugs are often prescribed by vets in case the dog is suffering from arthritis, sprain and surgery pain. It is also prescribed if your dog is suffering from osteoarthritis (a disease in which the cartilage cushioning the joints start to break down due to wear and tear causing the bones to rub against each other. The constant rubbing of the bones can cause permanent damage to the bones).
In our or your dog’s body, when there is damage to a cell, enzymes known as cyclooxygenases (COX) are released (enzymes are proteins/biocatalysts which speed up reactions in the body). These enzymes stimulate other nearby cells to produce prostaglandins. Prostaglandins are responsible for the following symptoms observed in canines and humans:
besides other effects
How do NSAIDs reduce pain and inflammation?
NSAIDs have the potential to act in two ways. They can either directly block the COX enzymes or it can block the prostaglandins which are produced by the action of the COX. by either mechanism, NSAIDs block the pain and cause a reduction in inflammation in animals.
However, it’s not a perfect world and NSAIDs are not the perfect drugs. Due to their effects on the OTHER protective functions of prostaglandins like (protect the stomach and intestinal lining, maintain blood flow to kidneys and support formation of platelets), blocking prostaglandins by the use of NSAIDs can lead to numerous side effects like:
Perforation (development of holes) in the stomach and intestinal walls
Failure of kidney function
Failure of liver function
The main side effects of NSAIDs are observed in the kidney, liver and digestive tract. Pin the article for later
Effect of NSAIDs on kidneys of dogs:
If for some reason, there is reduced blood flow to the kidneys, prostaglandins come into play and dilate (increase the width) of the blood vessels(vasodilation), allowing more blood to reach the kidneys. In case the dog is taking NSAIDs, chances are NSAIDs will block the prostaglandin from dilating the blood vessels supplying blood to the kidneys. This will cause less blood flow to the kidneys which may lead to acute kidney failure. This can result in shock or dehydration in dogs.
If the NSAID is used around surgery, intravenous (IV) fluids are generally administered before, after as well as during the anesthesia to help maintain proper blood flow to kidneys.
Effect of NSAIDs on the liver of dogs:
The side effects of NSAIDs on dog liver can be divided into two categories:
Toxicity which is dependent on the dose (dose-dependent toxicity)
Toxicity which does not depend on the dose of the NSAID (dose-independent toxicity)
In this case, the higher the dose, the more is the toxicity and resulting damage. This kind of toxicity is typically caused by an overdose of NSAID (dog consuming all the ibuprofen tablets of his guardian).
A note of caution: Keep all medicines (yours or your animals) in a sealed cabinet away from the reach of your human kids, fur kids as well as other animals.
Dose independent toxicity:
This type of toxicity can occur at any dose (even if the dosage is correct as per the body weight and breed). This is generally unpredictable and occurs when the dog’s liver has an abnormal sensitivity towards NSAIDs.
NSAIDs can have a detrimental effect on your dog
A word of advice:
Dogs who are already suffering from liver or kidney disease should not be prescribed NSAIDs. If your vet does so, get a second opinion before starting your pup on the medication.
Furthermore, if your dog has been prescribed NSAID for osteoarthritis, it is a good practice to get his or her blood tested to check for proper liver and kidney function before starting the drug and periodically for as long as the drug is taken. One more thing you can do is make sure your dog consumes a lot of water if he/she is on NSAIDs on a regular basis.
Effect of NSAIDs on the digestive tract (stomach and intestines) of dogs:
Regular use of NSAIDs can lead to problems in the digestive tract of dogs in a direct as well as indirect manner.
The direct effects are related to the physical properties of the drug. Since NSAIDs are slightly acidic in nature, they can cause irritation to the lining of the stomach.
The indirect effects of NSAID can be observed in its role in preventing the body from manufacturing prostaglandins (as I previously mentioned). When the production of prostaglandins is reduced or absent, it can lead to the digestive tract being more prone to damage (prostaglandins protect the stomach and intestinal lining). This can lead to the formation of pores (perforation) in the digestive tract.
A series of clinical trial done in 2013 showed that NSAID treatment let to adverse effects in 35 dogs of the 64 dogs enrolled in the study. The most common side effect observed was gastrointestinal disturbances.
FDA has approved the following NSAIDs for dog consumption:
Meloxicam (approved for cats too)
Robenacoxib (approved for cats too)
NSAIDs are normally administered either orally or by intravenous methods to dogs.
Be the voice of your pup
What can you do?
So far I have burdened you with tons of information about how bad NSAIDs can be for your dogs. In that case, what is the alternative? No one wants their beloved fur baby to go through any kind of pain. On the other hand, we also don’t wish for them to be administered drugs which might have side effects in the long run. Thus which is the right way to go and as dog guardians what can you do to help?
You can do the following: When your vet prescribes any pain killer, discuss with your vet about the following:
Inform the vet, if your dog has had any heart or digestive problems previously or has undergone surgery.
Is currently being administered any other medication. Without the knowledge of current medications, your vet cannot take the right decision of which medicine to administer. It is absolutely not recommended to give a combination of an NSAID and steroid or even 2 different types of NSAIDs at once. These combinations can have detrimental health effects on your dogs.
Monitor your pet, the entire time he/she is being administered NSAIDs. If you see any of the following signs, STOP giving the medication and immediately consult your vet:
In case your dog is diagnosed with osteoarthritis and is prescribed NSAIDs for the long term, discuss with your vet about getting some baseline blood and urine tests to determine the kidney and liver function. Also, talk to your vet regarding the frequency of the blood tests.
Things you can do to make NSAIDs safer for our pup:
Learn to identify the side effects listed above and take prompt action.
Keep your NSAID bottle out of reach of your inquisitive pup.
If your pup is on NSAID, take him or her in for regular urine and blood check-ups and general monitoring.
Report any or all of the side effects to your vet.
Do not hesitate to ask questions to your vet. Your questions might potentially save your dog’s life.
Finally remember, your dog is dependent on you to take the right decision and make the right choice. You are his/her caregiver, parent and best friend. Be the voice of your dog. They deserve the best care we all can offer.
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