Pain Medicine for Dogs

by Food and Drug Administration (FDA)

A decade ago, few drugs were available to treat pets in pain at home. Pups were spayed or neutered at the animal hospital, stitched up, and sent home without pain medication. And dogs with painful arthritis limped along without drugs that were safe and effective for long-term use.

Today, a new generation of nonsteroidal anti-inflammatory drugs (NSAIDs) is bringing relief to millions of dogs with joint problems or with pain after surgery.

"NSAIDs are extremely effective for controlling pain and inflammation in dogs," says Stephen F. Sundlof, D.V.M., Ph.D., director of the Food and Drug Administration's Center for Veterinary Medicine (CVM). "These are very valuable drugs that help many pets live to a ripe old age."

But like any drugs, NSAIDs carry a risk of side effects, or adverse reactions. Most adverse reactions are mild, but some may be serious, especially if the drugs are not used according to labeled directions. Some reactions result in permanent damage or even death.

"It's important for pet owners to be aware of the risks and benefits of all drugs, including NSAIDs, so that they can make informed decisions about their pets' health care," says Sundlof. "Owners who give their dog NSAIDs need to know the side effects to watch for that indicate their pet needs medical attention."

The most common side effects from NSAIDs include vomiting, loss of appetite, depression, lethargy, and diarrhea. Serious side effects include gastrointestinal bleeding, ulcers, perforations, kidney damage, and liver problems.

"The side effects of NSAIDs are very well known and very well documented," says Michele Sharkey, D.V.M., in the CVM's Office of New Animal Drug Evaluation. But this information is not always getting to the pet owner, she says. "If the pet owner can recognize a possible reaction, stop the medication, and get veterinary help, it could mean the difference between a good outcome and a disaster."

Safety and Effectiveness

The CVM, which regulates drugs for use in animals, has approved some NSAIDs for use in dogs with pain from degenerative joint disease (osteoarthritis) or with pain after surgery. These include Etogesic (etodolac), Rimadyl (carprofen), Metacam (meloxicam), Zubrin (tepoxalin), Deramaxx (deracoxib), Previcox (firocoxib), and Novox (generic carprofen).

NSAIDs help to control signs of arthritis, including inflammation, swelling, stiffness, and joint pain. Inflammation--the body's response to irritation or injury--is characterized by redness, warmth, swelling, and pain. NSAIDs work by blocking the production of prostaglandins, the body chemicals that cause inflammation.

The FDA considers approved NSAIDs to be safe and effective when used according to the label and when dog owners are informed about common NSAID adverse reactions.

And veterinarians are becoming increasingly aware of the advantages of recognizing and controlling pain, says Charles Lemme, D.V.M., a member of the American Veterinary Medical Association (AVMA), Clinical Practitioners Advisory Committee. "We recognize that pets are healing better and faster with pain control."

Lemme says that the emphasis on pain management may be partly because of the availability of the newer NSAIDs. "The NSAIDs we have available now are a lot safer than what we've had before and we're seeing far fewer side effects than before."

Before the newer generation of NSAIDs came along, "people were using NSAIDs such as aspirin in an attempt to mitigate arthritic pain," says Michael Andrews, D.V.M., president of the American Animal Hospital Association (AAHA). "We saw the consequence of their use," adds Andrews, who recalls seeing a client who gave her dog aspirin for six weeks, two times a day. "The dog had a bleeding nose that wouldn't stop."

"NSAIDs are used in many, many dogs and the frequency of problems is quite low," says Andrews. "The duration of use makes a difference in safety. If used for a day or two, the risks often are much lower than when used over long periods of time for a chronic arthritic condition."

Drugs used to control pain should be given only when necessary, and in the smallest dose that is effective, says Sharkey. "Arthritis waxes and wanes. Some animals get worse in cold weather. If the dog seems to improve to the point of not needing the drug, the owner should discuss continued use of the NSAID with a veterinarian."

An owner should never give an NSAID to a pet, or increase the dose or frequency of a drug, without the veterinarian's instructions, adds Sharkey. "Just like different people respond differently to a drug, the way each dog responds to an NSAID varies." Because of this individual response, no one NSAID is considered more effective than another, and because every NSAID can cause adverse reactions, none is considered safer than others.

If a pet is prescribed an NSAID, the CVM recommends that pet owners take the following steps to make sure they are fully informed about the drug and can make the best decision for their pet's health.

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