Non-steroidal anti-inflammatory drugs, also known as NSAIDs, are one of the most frequently prescribed pain relievers from veterinarians. With this high frequency of prescribing comes a proportional amount of side effects. This article aims to educate the public about the safe use of NSAIDs in pets: when they’re appropriate, when to avoid using them, and how to watch for dangerous side effects.

What are NSAIDs for pets indicated for and what benefits do they provide:

NSAIDs aren’t commonly used in cats because they cannot clear the drugs from their body very well. They should be avoided, especially in long term use, in cats for this reason. NSAIDs are indicated for two reasons in dogs: osteoarthritis and for pain relief after an operation. They can be used off label for many other reasons including an injury or pain when a veterinarian thinks they would be beneficial. They can benefit dogs by decreasing their pain and improving their quality of life. Let’s face it; no one wants to see their companion in pain and these drugs are proven to help reduce it.

How do NSAIDs for pets decrease inflammation:

All of the NSAIDs inhibit cyclooxygenase enzymes (COX enzymes). There are two major COX enzymes and are labeled COX-1 and COX-2. Both of the enzymes are involved in the pathways of inflammation, fever, blood clotting, and pain. However, COX-2 is found in inflamed cells only, and COX-1 is found all throughout the body, including the stomach. By inhibiting these enzymes, NSAIDs decrease the effects that the enzyme would normally have on the body. This will decrease the pain and inflammation associated with certain conditions such as osteoarthritis. Below is a table of all the NSAIDs that are available through VetRxDirect.

Drug	Active Ingredient	Dosage Form	Generic or Brand Name?	VetRxDirect Unit Price	Extra Notes About the Product
Rimadyl	Carprofen	Caplets or Chewable Tablets	Brand Name	$0.79-$1.40	Only Chewable Carprofen Product
Norocarp/Carprieve	Carprofen	Caplets	Brand Name	$0.47-$0.82
Vetprofen	Carprofen	Caplets	Brand Name	$0.49-$0.82	Can Get 240 Count Bottles
Novox	Carprofen	Caplets	Brand Name	$0.55-$0.97
Carprofen (Putney)	Carprofen	Caplets	Generic	$0.49-$0.78	Only Generic Carprofen Product
Metacam	Meloxicam	Oral Suspension (liquid)	Brand Name	$1.57-$2.50	Only Commercial Oral Liquid NSAD For Dogs
Meloxicam	Meloxicam	Tablets	Generic	$0.34-$0.69	Only Human Tablets Are Available
Piroxicam	Piroxicam	Capsules	Generic	$1.09-$2.69	VetRxDirect Compounds Suspensions And Multiple Doses That Aren’t Commercially Available
Etogesic	Etodolac	Tablets	Brand Name	$1.57-$1.95
Etodolac	Etodolac	Capsules	Generic	$1.89-$1.56	The Only Generic Is the Human Capsules
Deramaxx	Deracoxib	Chewable Tablets	Brand Name	$1.59-$3.53	COX-2 Selective. No Generic Available
Previcox	Firocoxib	Chewable Tablets	Brand Name	$1.48-$3.75	COX-2 Selective. No Generic Available
Onsior	Robenacoxib	Tablets	Brand Name	$3.33	For Use In Cats Only For Upto Three Days.

*The price is listed as per tablet, caplet, chewable tablet, or capsule. It is listed as per mL for the suspensions. Prices between suspension and tablets of the same product are only comparable when accounting for dose. Prices are subject to change and ultimately depend on the dosage form, strength and quantity ordered.

Courtesy of Roman Boed/Flickr

What is the difference between all the NSAIDs for pets?

The majority of the NSAIDs inhibit both COX-1 and COX-2, but there are a few that only inhibit COX-2. In humans, this selectivity for COX-2 helps prevent some side effects, mainly the risk for stomach bleeding. The two COX-2 selective products that we carry for dogs only have no evidence that shows a decreased risk of the severe side effects. There is also one COX-2 selective NSAID that is indicated for cats only, called Onsior. The NSAIDs carried by VetRxDirect that are sometimes used in cats are carprofen, meloxicam, and piroxicam. NSAID medications should always be used with extreme caution and for very short periods of time in cats.

There are multiple carprofen products available, and their prices can vary. The only one that isn’t comparable to the generic is the Rimadyl Chewable, as there is no chewable generic carprofen available at this time. When picking a product to buy, the generic is an acceptable choice because it will contain the same active ingredient as the brand name product, but will cost less. The liquid formulations of the products may be easier for you to give your pet, but they carry a larger price tag. Some of the NSAIDs work better for certain diseases and have varying side effect profiles. Your veterinarian will know which active ingredient is appropriate for your pet, when choosing between the different products.

What are the risks associated with NSAIDs for pets?

The more frequently reported side effects of NSAIDs include vomiting, diarrhea, depression, and decreased appetite. The use of NSAIDs carry a risk for stomach bleeding, ulcers, perforations (holes), kidney damage, and liver damage. The main problem with NSAID use is the population that they are targeted towards usually has an increased risk for experiencing these side effects from them. If used at the lowest effective doses for short periods of time, they have relatively low risk of these side effects. However, when they are used for osteoarthritis, they are often used for long periods of time which increases the risk of serious side effects. Pets with osteoarthritis are also often older in age, and using an NSAID in elderly animals can increase their risk for serious side effects. When dogs and cats are dehydrated they have an increased risk for kidney damage when using an NSAID.

How to use an NSAID for pets safely in dogs and cats:

Using an NSAID safely in your pet requires a good relationship with your veterinarian. You know your animal best and can tell if they have had any recent changes in health. Things that you need to watch for when your pet takes an NSAID are black tarry stools, dark urine, bloody vomit, and depression. If your pet has any of those symptoms, you need to call your vet right away. Giving an NSAID with their meal can help reduce the risk for stomach upset and irritation.You should also make sure they are well hydrated because of the risk for kidney damage. Educating yourself about your pet’s NSAID medication can reduce the life threatening risk that they carry and help keep them healthy!

Has your pet taken a NSAID before? Which one did your veterinarian prescribe and did your pet experience any side effects?

Please ask any remaining questions in the ‘Leave a Reply’ section of this post, or on the product’s ‘Question and Answer’ tab.

References:

• United States. Food and Drug Administration. FDA Center for Veterinary Medicine. Canine NSAIDs- What Dog Owners Should Know. By Carmela Stamper. FDA, n.d. Web. 15 Apr. 2014.
• Plumb, D. Etodolac. Plumb’s Veterinary Drug Handbook 7th ed. Pharma Vet Inc. Stockholm, WI. 2011.