In response to our last Q&A about aging dogs and arthritis, a number of readers raised concerns about the use of NSAIDs for treatment. Dr. Joseph Harari, a veterinary surgeon in Spokane who answered our earlier questions, addresses these concerns.

Question: What are NSAIDs?

Answer: Non-steroidal anti-inflammatory drugs are medications approved by the Food and Drug Administration (FDA) for the treatment of pain and inflammation associated with osteoarthritis or degenerative arthritis. Examples are Metacam, Rimadyl, Deramaxx, Previcox, Zubrin, and Etodolac (all trade names). Aspirin is also an NSAID but not registered by the FDA.

Question: How do NSAIDs work?

Answer: NSAIDs reduce pain, fever and joint inflammation by blocking the pathways that produce chemical mediators that cause those ill effects in the body.

Question: When are NSAIDs needed?

Answer: These drugs are indicated for, or should be used, to alleviate joint pain and inflammation (swelling, progression of arthritis) in dogs prior to, after, or in lieu of surgery.

Question: What are the potential side effects?

Answer: As with any drug used in an animal or human body, these medications can cause side effects, especially in patients with sensitivity to the medication. Most frequently with NSAID reactions, gastrointestinal system issues such as anorexia, vomiting, diarrhea, bleeding, ulcers and perforations have been reported. These side effects are not so common, in my opinion and experiences, so as to preclude the use of one (not combinations of!) these drugs in affected dogs. In addition to drug sensitivity, errors in dosing can often lead to problems.

Question: Can these side effects be lethal in some dogs?

Answer: Yes, gastrointestinal ulcers leading to perforations can be life-threatening so owners who notice that their dogs have lost appetite or are vomiting (the earliest signs of problems) should stop the medications and contact their veterinarians. Severe, life-threatening reactions are not commmon and can often be prevented if owners are attentive.

Question: Hasn't Rimadyl (and perhaps other NSAIDs) been linked to liver disease or the potential for developing it?

Answer: Rimadyl was mentioned in association with liver disease most commonly in Labrador retrievers. The cause and effect of this association has never been completely clarified and is of a rare ocurrence. Rimadyl has been and continues to be used safely in these dogs.

A rare, uncertain cause should not preclude owners from using it. If the connection would have been stronger and many problems reported, the drug would have been taken off the market. No manufacturer would want the lawsuits and negative publicity, nor would the FDA enjoy handling all of the complaints.

Question: What are other options in patients not tolerating NSAIDs?

Answer: Numerous other options exist for patients with osteoarthritis. These choices include: narcotic pain medications, weight control, physical therapy, acupuncture and joint supplements. The latter have not been proven scientifically to be of proven value, however, they are often used based on anecdotal reports of efficacy.
In summary, osteoarthritis in dogs is not usually a life-threatening condition and can often be controlled by judicious use of medicines, surgery and lifestyle choices.

Dr. Joseph Harari

Harari graduated from WSU's College of Veterinary Medicine in 1980 and later was a member of its faculty. He completed his surgical training at the University of Illinois and later was on its faculty, specializing in small-animal surgery. He has practiced in Seattle and now co-owns Veterinary Surgical Specialists, a surgical referral center in Spokane. Harari is a diplomate of the American College of Veterinary Surgeons and has lived with Labradors and cats for more than 30 years.

Photo courtesy of Joseph Harari

Read our past Q&As:

Veterinary QA follow-up: More on lumps and bumps
Veterinary QA: Should you dress your pet?
Veterinary Q&A: Lumps and bumps
Veterinary Q&A: Puppy and geriatric exams
Veterinary QA: What dogs can safely chew
Veterinary QA: Why does it cost so much to clean a dog's teeth?
Veterinary QA follow-up: More on cleaning a dog's teeth
Veterinary QA: When to spay or neuter

Do you have a question about pet health? Ask now! We'll pose some of your questions to a local vet in an upcoming post.